Planning MS: It just takes a little longer


Denney DR et al. Deficits in Planning Time but not Performance in Patients with Multiple Sclerosis.Arch Clin Neuropsychol 2011 Dec 15. [Epub ahead of print]

Studies of planning ability typically involve some version of the Tower of Hanoi or Tower of London tests. When these tests are administered to patients with multiple sclerosis (MS), the findings pertaining to planning “performance” have been conflicting.

Possible reasons for failures to find deficits in planning performance among MS patients are: (a) the patients typically have relapsing-remitting MS (RRMS) of mild severity and short duration and thus little cognitive impairment relative to those with more advanced disease; (b) the problems composing the tests are too simple and differences between patients and controls are therefore obscured by ceiling effects; and (c) the scoring system typically used permits participants to earn points for successful solutions on later trials after failing the initial attempt on each problem, thereby further diluting the difference between patients and controls.

The present study compared the performance of patients with both relapsing-remitting and secondary progressive disease with that of healthy controls on a more challenging version of the Tower of London test. Patients exhibited lengthier planning times on the test, greater disparity in their average planning times from those of controls as the difficulty level increased, and greater individual variability in their planning times across the full set of problems. However, no differences in planning performance were found between patients and controls or between RRMS and secondary progressive MS patients. Performance differences in other studies may be attributable in part to the imposition of time limits for solving each problem and the disproportionately adverse effect such time limits have on patients’ performance.

Tower of Hanoi. The objective of the puzzle is to move the entire stack to another rod, obeying the following rules: Only one disk may be moved at a time. Each move consists of taking the upper disk from one of the rods and sliding it onto another rod, on top of the other disks that may already be present on that rod and No disk may be placed on top of a smaller disk.

The results say it all, it means that sometimes you may need a little longer to do things. This sort of shows that the brain can be plastic (abilty of nerve circuitary to adapt to change) during MS. For example whilst there may damage to some circuits to get message (nerve impulses) from say A to B, it adapts to go from A to C to D to B so it gets there in the end but may be abit slower.

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