Investigation of the effect of cognitive fatigue on mental imagery in multiple sclerosis patients

Objective: Mental imagery is a process in which the person visualizes and rehearses the determined movement without actually revealing any movement. In the literature, the effects of mental imagery on different functions have been investigated in healthy individuals and many diseases such as stroke, multiple sclerosis (MS), Parkinson's disease, and Alzheimer's disease. These studies have shown that mental imagery is affected by many factors. Multiple sclerosis (MS) is a demyelinating disease, and due to the variety of localization of demyelination, a wide range of findings may occur, from balance loss to sensory disorders, from muscle weakness to depression. Cognitive fatigue is one of these symptoms. Although cognitive impairment is not detected in all MS patients, it has been reported that more than 50% of them have cognitive fatigue. The literature recommends mental imagery studies for MS patients with cognitive fatigue. However, there is no study showing the effect of cognitive fatigue on mental imagery. Many publications are showing the relationship between fatigue and motor function in MS patients. There are many studies examining the relationship between lower extremity strength and fatigue. Studies examining the relationship between cognitive fatigue and extremities are extremely limited. Yozbatiran et al. The study, which examined the correlation between upper extremity function and fatigue in MS patients, is the only study in the literature on the subject. To the best of our knowledge, there is no study on how much cognitive fatigue affects lower and upper extremity functions. The aim of our study, which we planned based on these deficiencies in the literature; is To examine how cognitive fatigue in MS patients affects mental imagery and to determine its effect on upper and lower extremity motor functions. Method: MS patients with EDSS scores between 0 and 4 will be included in the study. Individuals meeting the inclusion criteria will be randomized based on odd or even odds of file number and divided into two groups study and control groups. The physical activity levels of the individuals in both groups were determined by the International Physical Activity Scale, the depression and anxiety levels by the Beck Depression Scale and the Beck Anxiety Scale, the cognitive fatigue levels by the visual analog scale and the mental imagery by the kinesthetic and visual imagery questionnaire, the movement imagery questionnaire, the motor imagery ability test, It will be evaluated by the 9-hole nail test, the 10-meter walking test, and the trailing test. One week later, the tests will be repeated for both groups. However, a protocol based on answering neuropsychiatric tests will be applied to the individuals in the study group to increase cognitive fatigue before the evaluation. Conclusion: In this study, the effect of cognitive fatigue on mental imagery in MS patients will be shared in the literature. Discussion: The results obtained from the study will be presented by discussing similar studies in the literature.