Functional Performance in Patients With MS Limited by Sensory Processing Difficulties

Multiple sclerosis (MS) is a chronic auto-immune disease that attacks the central nervous system, interfering with the brain’s ability to correctly send signals to the body. Scientists believe a combination of environmental and genetic factors are to blame.

According to research published online with Disability and Rehabilitation, the sensory processing difficulties that persons with MS experience result in hypo or hypersensitivity to sensory input. People who are hypersensitive have a low neurological threshold compared with those who are hyposensitive. Daily routines, relationships, and quality of life can be disrupted by both, according to the study’s investigators.

Many studies have been done on how deficits in cognitive and motor abilities affect daily functioning, but not on how difficulties processing sensory stimuli impact the same measure. These investigators examined how sensory processing, along with disease severity and cognitive impairment, help to predict functional behavior in patients with MS and affect quality of life.

There were 2 cohorts in the study, with an age range of 23 to 63 years: 61 patients with MS, with (n = 43) and without cognitive impairment (n = 18), and 36 in the control group. All were asked to fill out 3 self-assessments: the Adolescent/Adult Sensory Profile, Functional Behavior Profile, and MS Functional Composite.

Compared with the control group, results show that those with MS (cognitive impairment notwithstanding) cannot register sensory stimuli as well and had greater sensory sensitivity and avoidance—both of which correlate with, but don’t predict, worse functional status and reduced daily life function. Between the MS groups, those with cognitive impairment also had less of an ability to register sensory input.

Overall, the control group had, according to the investigators, better total functional behavior profiles while those with MS had more difficulty processing sensory stimuli, which showed in 3 distinct patterns:

1. Low tendency to register sensory input
2. Greater sensitivity
3. Greater avoidance

These findings need to be interpreted in light of some study limitations. Chief among these is the results may not be generalizable and the self-reporting nature of the data could limit the objectivity of responses from the study participants.

"This study underscores the influence of sensory processing in MS, and the importance of screening patients for these disorders," stated Yael Goverover, OTR/L, PhD. “Further research is needed to explore whether sensory processing difficulties could be of predictive value for disease severity and cognitive decline.”

Suggestions for future research and awareness are to combine objective measures of sensory processing with self-reported difficulties, to investigate if difficulties processing sensory stimuli can predict cognitive decline in the MS population, and a 2-pronged intervention program for patients with MS and their caregivers that “stresses the importance of sensory processing to everyday life and quality of life and provides strategies to enhance the inclusion and function of people with MS in daily life.”

References

Engel-Yeger B, DeLuca J, Hake P, Goverover Y. The role of sensory processing difficulties, cognitive impairment, and disease severity in predicting functional behavior among patients with multiple sclerosis [published online August 27, 2019]. Disabil Rehabil. doi: 10.1080/09638288.2019.1653998.