Cognitive impairment is significantly correlated with the speed of gait in patients with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) with mild disability, found a new study published in the journal BMC Neurology. Moreover, the degree of disability is significantly correlated with stance phase time. 

“Our findings may imply that early detection of a decrease in gait speed and an increase in stance phase time can predict the progression of cognitive impairment in patients with MS/NMO with mild disability,” the study authors said.

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“In other words, this may also mean that caring for cognitive function in patients with MS/NMO might be helpful in maintaining good walking ability,” they added.

Even though gait disturbances are 1 of the complications that have a great negative impact on patients’ quality of life, their association with other clinical variables of NMOSD and MS is not clear, the researchers noted.

In the present study, a team of researchers from Korea used a computerized gait analysis system to assess gait disturbances and their association with various clinical variables in 19 patients with NMOSD and 14 patients with MS who were still able to walk on their own.

The team recorded the patients’ disease duration, medications, body mass index, hand grip power, and muscle mass. They also assessed their Beck Depression Inventory score-2 (BDI), Montreal Cognitive Assessment (MOCA) score, and fatigue scale using the Functional Assessment of Chronic Illness Therapy-fatigue (FACIT-fatigue) scale. Finally, their Expanded Disability Status Scale (EDSS) was evaluated by a trained neurologist.

The results showed that gait speed was the 1 parameter that showed a significant positive correlation with MOCA, while the stance phase time was the 1 parameter that showed a significant negative correlation with the EDSS score. 

The researchers also reported a significant positive correlation between hand grip strength and skeletal muscle mass. Finally, there was a significant negative correlation between the FACIT-fatigue scale score and the BDI.

“Our findings suggest that gait disturbance and cognitive deficits in patients with MS/NMO are closely correlated,” the researchers concluded.


Chang MC, Lee BJ, Yang D, et al. The association between cognition and gait disturbance in central nervous system demyelinating disorder with mild disability. BMC Neurol. Published online April 29, 2023. doi:10.1186/s12883-023-03210-w