Correlation between psychomotor functions and quality of life in patients with relapsing remitting multiple sclerosis and migraines

Uvod: Multipla skleroza (MS) i migrena kronične su neurološke bolesti sa značajnim utjecajem na kvalitetu života i psihomotoričke funkcije. Cilj: Cilj ovog istraživanja bio je procijeniti psihomotoriku i multidimenzionalno istražiti razinu kvalitete života u ranom stadiju relapsno remitirajućeg oblika multiple skleroze i migrene. Metode: U istraživanju je sudjelovalo 90 ispitanika (30 s migrenom – s aurom ili bez nje, 30 s RRMS-om i 30 zdravih kontrolnih ispitanika). Grupe su bile složene prema spolu, dobi i stupnju obrazovanja. Procijenjeni su pomoću Upitnika zdravstvenog statusa (SF-36), Indeksa osobne dobrobiti – verzija za odrasle (PWI-A) i psihomotornih testova (Fittsov tapping test, O'Connorov deksterimetar, dinamometar i aparat za ispitivanje vremena reakcije). Rezultati: Bolesnici s RRMS-om i migrenom u većini domena KŽ-a i KŽOZ-a postigli su značajno niži rezultat u odnosu na zdrave ispitanike, dok se u većini domena nisu međusobno razlikovali, kao ni u psihičkom zdravlju. Rezultati Fittsova tapping testa upućuju na to da bi test mogao biti dobra alternativa standardnom protokolu magnetske rezonancije u slučajevima kada se sumnja da su „nevidljive lezije― glavni uzrok patomorfoloških promjena odgovornih za sadašnju kliničku sliku; također su pokazali značajne promjene koje su bile u korelaciji s dužinom liječenja. Vrijeme odluke bilo je produženo u bolesnika s MS-om, što ukazuje na usporenje senzorne obrade kao posljedica poremećaja vremena senzornog procesa. Međutim, pronađeno je kako je vrijeme odluke indikativno i za oboljele od migrene, što je u skladu s novijim hipotezama patofiziologije. Zaključak: Procjena zdravlja i kvalitete života može se uključiti kao metoda evaluacije liječenja i u klinička ispitivanja kako bi se osigurao potpuni pregled zdravstvenog stanja pacijenata. Nadalje, s obzirom na to da su psihomotorički testovi neovisni o istraživaču ili jeziku, mogli bi se koristiti u svakodnevnoj praksi, uz standardne kliničke i neuroradiološke protokole.Background: Multiple sclerosis (MS) and migraine are chronic neurologic disorders with a significant influence on quality of life and psychomotor functions. Objective: The aim of this study was to explore psychomotor functions and investigate quality of life in patients with relapsing-remitting MS and migraine. Methods: This study included 90 subjects [30 with migraine (with or without aura), 30 with RRMS] and 30 healthy controls. Groups were matched by gender, age and level of education. They were assessed by - Health status questionnaire (SF-36), Personal Wellbeing Index—Adult Questionnaire (PWI-A) and psychomotor tests (Fitts's tapping test, O'Connor dexterity, reaction and decision time tests, dynamometric strength tests). Results: Patients with RRMS and migraine had significantly worse self-reported QoL and HRQoL compared to HC, while they did not differ mutually in other QoL dimensions nor in mental health. The results of the psychomotor Fitt's tapping test, which showed significant changes correlated with the duration treatment in patients with RRMS suggest that this test might be a good alternative to standard magnetic resonance protocol, when ―silent lesions― are suspected to be the main cause of pathomorphological changes responsible for the current clinical picture. Similarly, longer time decision in patients with RRMS suggest that a delay in sensory processing might be a consequence of malfunctioning of the sensory processing time. However, longer time decision is also indicative for migraine patients, which is in line with some recent pathophysiological hypotheses. Conclusion: Assessment of health status and quality of life might be included as a treatment evaluation method and in clinical trials to provide a complete view of patients’ health status. Psychomotor tests, as were shown to be valid irrespective of the investigator or language might be used in everyday practice, next to clinical and neuroimaging standard protocols