Decision-making impairment in patients with multiple sclerosis: a case–control study

Abstract

ObjectivesTo assess decision-making under explicit risk conditions in relapsing–remitting multiple sclerosis patients and its relationship to decisions made under conditions of ambiguity. To assess cognitive functions related to decision-making performance in patients with multiple sclerosis (MS).SettingMS center in Buenos Aires, Argentina.Participants27 patients with relapsing–remitting multiple sclerosis and 27 sex-matched, age-matched and education-matched healthy controls.InterventionNeuropsychological assessment and decision-making evaluation using the Game of Dice Task and the Iowa Gambling Task.OutcomesGame of Dice Task and the Iowa Gambling Task scores.ResultsPatients with MS showed significantly poorer performance on the Game of Dice Task, choosing disadvantageous dice more often (p=0.019), as well as significantly lower overall scores in the Iowa Gambling Task (p=0.007). Block analysis showed that patients with MS and controls had scores that were comparable for blocks 1 and 2 (p=0.15 and p=0.24, respectively). Conversely, patients with MS scored poorly on blocks 4 (p=0.003) and 5 (p=0.023), the last two of the test, corresponding to decision-making under conditions of risk. Finally, the Game of Dice Task performance together with the last three blocks of the Iowa Gambling Task were correlated with visuospatial learning, processing speed and working memory but not with executive functioning.ConclusionsPatients with MS showed deficits in decision-making under risk conditions, which might be related to deficits in visuospatial learning, processing speed and working memory.

Electrophysiological correlates of decision making impairment in multiple sclerosis

“…The objective of this study was to analyze the DM process in patients with MS, using the ERP technique. The obtained results offer electrophysiological evidence of DM impairment in patients with MS, which has been shown in previous behavioral studies (Kleeberg et al ., ; Nagy et al ., ; García‐Molina et al ., ; Roca et al ., ; Simioni et al ., ; Farez et al ., ).…”

“…The sample consisted of 20 patients diagnosed with MS by the National Institute of Neurology and Neurosurgery (INNNMVS) in Mexico City, and 20 healthy control subjects, similar to the patient group in terms of age and educational level. The sample size was based on previous behavioral studies assessing DM in MS (Kleeberg et al, 2004;Nagy et al, 2006;Garc ıa-Molina et al, 2008;Farez et al, 2014) and previous electrophysiological studies exploring ERPs associated with DM (Masaki et al, 2006;Martin & Potts, 2009). Patients were selected based on the following criteria: (i) MS diagnosis by a neurologist based on the guidelines of the International Panel on the Diagnosis of Multiple Sclerosis (McDonald et al, 2001), (ii) a remission period of at least one month as the previous episode's symptoms, (iii) aged 18-65, (iv) a minimum of 6 years of basic education, and (v) a score between 2.5 and 4.5 according to the Expanded Disability Status Scale (Kurtzke, 1983).…”

A Systematic Review of Discrete-Choice Experiments and Conjoint Analysis Studies in People with Multiple Sclerosis

“…For example, they need to consider how much negative impact from side effects on quality of life and daily routine is acceptable in order to potentially slow down accrual of disability several years later. Moreover, many PwMS experience effects on cognition of their disease [12][13][14][15][16], which may impact on their ability to give considered responses in surveys.…”

Decision-making under explicit risk is impaired in multiple sclerosis: relationships with ventricular width and disease disability

“…Two previous MS studies used the GDT. Farez and others (2014) [ 23 ] reported deficits in 27 relapsing-remitting MS patients with minimal disability (mean Expanded Disability Status Scale [EDSS] [ 24 ] = 1.03) and short disease duration (mean = 7.9 months). Patients’ GDT performance was related to processing speed and visual memory performance [ 23 ].…”

“…Farez and others (2014) [ 23 ] reported deficits in 27 relapsing-remitting MS patients with minimal disability (mean Expanded Disability Status Scale [EDSS] [ 24 ] = 1.03) and short disease duration (mean = 7.9 months). Patients’ GDT performance was related to processing speed and visual memory performance [ 23 ]. Conversely, Cogo and others (2014) [ 25 ] found 60 relapsing-remitting MS patients with minimal disability (mean EDSS = 1.4) but longer disease duration (mean = 40.8 months) unimpaired on the GDT.…”