NIH grant supports PhD student’s study into fear of falling with MS
Aim is to break 'vicious cycle' affecting overall health, life quality
A grant from the National Institutes of Health (NIH) is supporting a U.S. study into the physical, cognitive, and psychological responses that may underlie a fear of falling in people with multiple sclerosis (MS).
Specifically, the $96,812 two-year grant by the agency’s Eunice Kennedy Shriver National Institute of Child Health and Human Development will support a study into factors related to such fears, and the “vicious cycle” that results, in about 40 people with relapsing-remitting MS.
It was given to Taylor Takla, a PhD candidate in the translational neuroscience program at Wayne State University in Michigan, for her project “Investigating Fear of Falling in Multiple Sclerosis: An Interplay of Neural, Motor, Cognitive, and Psychological Factors.”
“Fear of falling is a major issue for people with MS, leading to serious negative health and quality of life outcomes,” Takla, who plans to become a neuroscientist with a specialty in MS, fear of falling, and fall prevention, said in a university press release. “It’s both a risk factor and a consequence of experiencing a fall.”
Fear of falling risks falls by limiting confidence and physical activity
Balance impairments, muscle weakness, fatigue, and changes in muscle tone are among disease symptoms affecting movement in people with MS. Fear of falling is a major concern, as falls can cause serious injuries, diminish patients’ quality of life, and restrict their independence. A combination of factors, described as personal, environmental, and activity-related in an earlier study, has been suggested as the basis for a fall risk.
Fear of falling is described in the project as “a heightened emotional response to the possibility of losing balance, accompanied by an inclination to avoid such situations.”
It “creates a vicious cycle where individuals become less confident in their balance, reduce their participation in activities, get physically weaker, and experience subsequent increased fall risk and greater fear of falling,” Takla said. “This cycle results in social isolation, psychological distress, and reduced overall well-being.”
Her long-term goal is to help break that cycle, which she reports as affecting 60% of all patients, by both lowering the number of likely falls and increasing physical activity across the MS community.
Takla’s hypothesis is that neural and behavioral factors associated with motor, cognitive, and psychological functioning contribute to a fear of falling, and help to predict a person’s physical activity and falls over time. But the neural factors — those relating to the nervous system — “remain largely unknown,” she stated.
Study to involve mix of brain imaging and assessment tests
Looking to go beyond studies focused on brain regions controlling motor function, she plans to use MRI to image three specific brain areas: the cerebellum, involved in the control of balance and movement; the hippocampus, implicated in memory and learning; and the amygdala, a major processing center for emotions. In the same study visit, patients will undergo motor, cognitive, and psychological assessments to explore balance and walking issues, anxiety, and executive functioning — mental skills that enable planning, focusing attention, remembering, and juggling multiple tasks.
Participants will then be followed for six months to collect data related to their fear of falling, actual falls, and physical activity.
“Through the combination of advanced MRI techniques and a comprehensive evaluation of behavioral functioning, we hope to gain a more complete understanding of the fear of falling and its downstream consequences than by using any single measure alone,” Takla said.
Findings will be analyzed by Takla, a university advisory committee, and experts at the NIH agency.
Takla is being mentored by Nora Fritz, PhD, an associate professor of physical therapy at the university’s Eugene Applebaum College of Pharmacy and Health Sciences, who led a recent study into mobility and cognitive function in people with MS.
Takla previously was awarded the Whitaker Prize for Young Investigators at the Consortium of Multiple Sclerosis Centers 2023 annual meeting for an abstract showing “substantial promise in increasing the understanding of MS.”
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