Neurocognitive correlates of physical activity in multiple sclerosis: metacognition and cognitive flexibility

Multiple sclerosis (MS) is a neurological condition that can impair both physical and cognitive impairments. The aim of this study, to compare physical activity (PA) levels, cognitive flexibility, metacognition and attention skills between individuals with MS and healthy individuals and to examine the relationship between PA and cognitive flexibility, metacognition and attention skills. The comparison of these abilities with healthy individuals enables the identification of MS-related functional deficits and supports the development of appropriate intervention programs.

This cross-sectional study consisted of two groups. The study group included 35 individuals with relapsing remitting type MS who were diagnosed with MS by a neurologist. The control group included 33 healthy volunteers. Both groups were evaluated in terms of demographic information, PA level (International Physical Activity Questionnaire (IPAQ)), cognitive flexibility (The Cognitive Flexibility Inventory (CFI)), metacognition (The Metacognitions-30 Scale (MCS-30)) and attention (Stroop test-TBAG Form (STT) and the Trail Making Test (TMT) status of the participants. The differences between the two groups regarding these parameters were assessed, and their relationship with PA level in individuals with MS was examined.

The two groups were similar in terms of age, gender and body mass index (p > 0.05). Compared to healthy controls, individuals with MS had lower IPAQ score and CFI scores (p < 0.05) and higher scores on MCS-30 (p < 0.05). Individuals with MS had higher STT and TMT completion times than healthy individuals in all sections (p < 0.05). There was a low statistically significant negative correlation between the IPAQ scores of individuals with MS and the completion times of the fourth and fifth parts of the Stroop Test (r=-0.364, -0.402; p < 0.05).

PA level, cognitive flexibility, metacognition and attention are negatively affected in individuals with MS. Therefore, in addition to routine assessments, it is important to perform detailed PA level and cognitive assessment in individuals with MS in order to plan rehabilitation.