Role of executive functions in prospective memory in multiple sclerosis: Impact of the strength of cue-action association

J Clin Exp Neuropsychol. 2016;38(1):127-40. doi: 10.1080/13803395.2015.1091063. Epub 2015 Nov 20.

Abstract

Objectives: Patients diagnosed with multiple sclerosis (MS) often report prospective memory (PM) deficits. Although PM is important for daily functioning, it is not formally assessed in clinical practice. The aim of this study was to examine the role of executive functions in MS patients' PM revealed by the effect of strength of cue-action association on PM performance.

Method: Thirty-nine MS patients were compared to 18 healthy controls matched for age, gender, and education on a PM task modulating the strength of association between the cue and the intended action.

Results: Deficits in MS patients affecting both prospective and retrospective components of PM were confirmed using 2 × 2 × 2 mixed analyses of variance (ANOVAs). Among patients, multiple regression analyses revealed that the impairment was modulated by the efficiency of executive functions, whereas retrospective memory seemed to have little impact on PM performance, contrary to expectation. More specifically, results of 2 × 2 × 2 mixed-model analyses of covariance (ANCOVAs) showed that low-executive patients had more difficulty detecting and, especially, retrieving the appropriate action when the cue and the action were unrelated, whereas high-executive patients' performance seemed to be virtually unaffected by the cue-action association.

Conclusions: Using an objective measure, these findings confirm the presence of PM deficits in MS. They also suggest that such deficits depend on executive functioning and can be reduced when automatic PM processes are engaged through semantic cue-action association. They underscore the importance of assessing PM in clinical settings through a cognitive evaluation and offer an interesting avenue for rehabilitation.

Keywords: Multiple sclerosis; cognitive impairment; episodic memory; executive functions; prospective memory.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Association*
  • Cognition Disorders / etiology*
  • Cues*
  • Executive Function / physiology*
  • Female
  • Humans
  • Male
  • Memory, Episodic*
  • Middle Aged
  • Multiple Sclerosis / complications*
  • Neuropsychological Tests
  • Regression Analysis
  • Severity of Illness Index
  • Surveys and Questionnaires