Impaired temporal processing in multiple sclerosis

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that damages grey and white matter and reduces neural transmission efficiency. Volumetric MRI studies indicate early neurodegeneration in subcortical structures, including the basal ganglia (BG), with microstructural damages and altered tissue anisotropy reported across all MS subtypes, affecting BG functional connectivity while also being linked to fatigue. Given the BG's central role in temporal processing, we hypothesized that people with MS (pwMS) would show impaired perceptual and motor timing. Twenty-two pwMS (14 females) with relapsing-remitting MS completed the Battery for the Assessment of Auditory Sensorimotor and Timing Abilities (BAASTA) on a tablet, performing perceptual tasks and finger-tapping motor tasks. Compared to normative data, pwMS exhibited increased motor variability during unpaced tapping and reduced synchronization consistency to rhythmic auditory cues. Perceptual deficits included poorer detection of metronome alignment with musical beats and reduced sensitivity to deviations from a regular beat. These perceptual impairments correlated with higher patient-reported Expanded Disability Status Scale (prEDSS) scores and perceived fatigue levels, as evaluated with the Multidimensional Fatigue Inventory (MFI). These findings suggest timing measures as a potential candidate for behavioral biomarkers of disease progression and fatigue in MS.