ClinicSpeak & BrainHealth: how safe are your road-crossing skills?

MS impairs your ability to safely cross the road; particularly if you are distracted. #MSBlog #MSResearch #ClinicSPpeak #BrainHealth

“The hidden dangers and consequences of having MS are enormous.  The majority of MSers have reduced brain reserve, which potentially gets worse with time and age. As a result of this MSers find it very difficult multi-tasking and if they do multitask  they tend to under perform. The study below shows that MSers have a reduced ability to cross the road, particularly when distracted (phone conversation).  This study was done using a virtual street. These findings have major implications for MSers in that they need to be vigilant about performing tasks that expose them to danger. This study is another example of why it is so important for MSers to take the treatment of their MS seriously; it is as much your responsibility to maximise your brain health as it is the responsibility of your healthcare professional (HCP). Maintaining brain and neuronal reserve is what will protect you when crossing the street and protect you from age-related cognitive decline. At ECTRIMS I will be co-chairing a teaching session on brain health to activate HCPs to the importance of the holistic management of MS; i.e. ‘time is brain‘. As soon as the teaching course is completed I will post the materials online, including a Podcast for you consume, digest and reflect on.”

“Please note we can reduce, and hopefully prevent, the ravages of MS, but at present we can’t repair the nervous system. The recovery of function that occurs in MSers treated with DMTs probably involved endogenous (self) repair mechanisms that are linked to reserve and age. The ability to recover therefore drops off as MS progresses and with ageing. The underlying message therefore is early effective treatment. Please read the following document that explains how you can optimise your treatment and hopefully your brain health.”

Stratton et al. Virtual street-crossing performance in persons with multiple sclerosis: Feasibility and task performance characteristics. Traffic Inj Prev. 2016 Sep 7:1-9.

OBJECTIVES: Multiple sclerosis (MS) is a neurological disease that commonly results in physical and cognitive dysfunction. Accordingly, MS might impact the ability to safely cross the street. The purpose of this study was to examine the feasibility of a simulated street-crossing task in persons with MS and to determine differences in street-crossing performance between persons with MS and non-MS controls.

METHODS: 26 participants with MS (median Expanded Disability Status Scale [EDSS] score = 3.5) and 19 controls completed 40 trials of a virtual street-crossing task. There were 2 crossing conditions (i.e., no distraction and phone conversation), and participants performed 20 trials per condition. Participants were instructed that the goal of the task was to cross the street successfully (i.e., without being hit be a vehicle). The primary outcome was task feasibility, assessed as completion and adverse events. Secondary outcomes were measures of street-crossing performance.

RESULTS: Overall, the simulated street-crossing task was feasible (i.e., 90% completion, no adverse events) in participants with MS. Participants with MS waited longer and were less attentive to traffic before entering the street compared with controls (all P < .05). Participants with MS also took longer to cross the street and were closer to oncoming vehicles when exiting the street compared to controls (all P < .05). When distracted, all participants took longer to initiate crossing, took longer to cross the street, and made more head turns while crossing (all P < .05). There were no significant group by condition interaction effects (all P > .05).

CONCLUSIONS: A virtual street-crossing task is feasible for studying street-crossing behavior in persons with mild MS and most individuals with moderate MS. Virtual street-crossing performance is impaired in persons with MS compared to controls; however, persons with MS do not appear to be more vulnerable to a distracting condition. The virtual reality environment presents a safe and useful setting for understanding pedestrian behavior in persons with MS.

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.


  • I have heard Dr. Motl speak when at the University of Illinois, now he is at The University of Alabama-Birmingham. He is very passionate about helping MSers within the department of Kinesiology. The only problem is that the National MS Society funds studies such as this and in my opinion is wasting resources. There is also a study using a specific diet to limit inflammation conducted by Dr. Wahls at the University of Iowa. The Dr. also has MS and believes that her diet has alleviated her disease. The NMSS is funding this study to the tune of $ 1 million. I believe the money is wasted on such studies.

    • No one disputes eating high fiber, low fat diets and the study of high dose biotin is planned but to use an exorbitant amount of money for such studies seems wasteful. Are we saying that eating certain diets can reduce the symptoms of MS due to their anti-inflammatory components? We can also say that weight reduction is important in MSers as being overweight is also inflammatory.

    • For years people have made money on books, regimes, advice on MS. It will go on and on until the cause is found and the disease is eradicated. Quite a few people will be out of a job. The money should be spent in the real science not diets that are widely available for free.

  • Interesting. Unfortunately I've seen a number of studies suggesting that drivers frequently target disabled people in the roads. So perhaps not entirely our faulty brains…

  • Last weekend I was able to justify that binge watching Narcos was good for my brain health since I was learning Spanish 🙂

  • Crossing the road is one of my biggest fears. Looking left and right sends my head wobbly. If I am with someone, I ask them can I take their arm to cross the road.

  • I don't cross the road anymore. Before I surrendered my driving licence I would get in my car and drive to space on the other side or I would go home if there was nowhere to park. Nothing to do with cognitive impairment, just too dangerous.

By Prof G



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