Episodic foresight in multiple sclerosis.

Abstract

Objective: Episodic foresight refers to the ability to imagine future scenarios and to then use this imaginative capacity to guide future-directed behavior. Multiple sclerosis (MS) is associated with deficits generating the phenomenological characteristics of future events (the imaginative component of episodic foresight), but no study to date has tested whether MS is also associated with deficits using episodic foresight to appropriately guide future-directed behavior. Method: Forty people with relapsing-remitting MS (RRMS) and 40 demographically matched healthy participants completed a validated measure that met strict criteria for assessing the functional application of episodic foresight, Virtual-Week Foresight (VW-Foresight). Results: Overall, people with RRMS did not differ significantly relative to comparison participants in how likely they were to spontaneously acquire items that would later allow a problem to be solved and were also just as likely to subsequently use these items to solve the problem. However, the latter group difference was large in magnitude and just failed to attain significance. Higher levels of depression were significantly related to performance on this same "use" component of foresight in the RRMS group, and depressed RRMS participants were significantly impaired in this aspect of foresight relative to both healthy participants and nondepressed RRMS participants. The depressed MS subgroup also differed from the nondepressed subgroup in their ability to perform instrumental activities of daily living. Conclusions: People with RRMS who present with heightened levels of depressive symptomatology also appear to be at greater risk of experiencing specific problems with episodic foresight. Key PointsQuestion: The present study provided the first test of whether multiple sclerosis (MS) is associated with deficits using episodic foresight to appropriately guide future-directed behavior. Findings: People with relapsing-remitting MS (RRMS) were impaired on a validated measure that met strict criteria for assessing the functional application of episodic foresight, but only when depressive symptoms were a prominent clinical feature. The depressed MS subgroup also differed significantly from the nondepressed subgroup in their ability to perform instrumental activities of daily living. Importance: Episodic foresight plays a key role in many activities that are fundamental to independent living. Next Steps: Future work should examine the nature and real-world implications of episodic foresight failures in people with RRMS, focusing in particular on those who present with heightened levels of depressive symptomatology.

Episodic foresight is impaired following acute alcohol intoxication

“…Episodic foresight. VW-Foresight (see Figure 1) is a computerized task designed to meet strict experimental design criteria for demonstrating episodic foresight and that is sensitive to episodic foresight difficulties associated with normal adult ageing (Lyons et al, 2014) as well as various clinical disorders (Coundouris et al, 2022;Lyons et al, 2016Lyons et al, , 2019Manchery et al, 2022;Terrett et al, 2017). VW-Foresight has the appearance of an engaging board game.…”

“…At present, VW-Foresight is the only behavioural measure meeting these criteria that is suitable for adults (for development and task details, see Lyons et al, 2014 ). Although the sensitivity of VW-Foresight to a pharmacological experimental manipulation remains to be established, it has been shown to be sensitive to foresight difficulties associated with long-term opiate use (Terret et al, 2017), developmental changes in late adulthood ( Lyons et al, 2014 ), and many neurological and psychiatric disorders ( Coundouris et al, 2022 ; Lyons et al, 2016 , 2019 ; Manchery et al, 2022 ).…”

Oral health‐related quality of life is more strongly correlated with mental health than with oral health in relapsing–remitting multiple sclerosis

“…Finally, oral care capacity is important to consider in any disorder that affects cognitive and/or motor capacity, as it speaks directly to whether the actual ability to engage in oral self-care is compromised. Although neurocognitive impairment is common in MS, 13,14 it appears to be unrelated to oral health. 15 However, other MS-related symptoms such as motor disturbances might negatively impact oral care capacity.…”