Maria Sepúlveda1, Begoña Fernández-Diez1, Elena H Martínez-Lapiscina1, Sara Llufriu1, Nuria Sola-Valls1, Irati Zubizarreta1, Yolanda Blanco1, Albert Saiz1, Dino Levy2, Paul Glimcher3, Pablo Villoslada4. 1. Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain. 2. Coller School of Management and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel. 3. Center for Neural Science, New York University, New York, NY, USA. 4. Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain/Department of Neurology, University of California-San Francisco (UCSF), San Francisco, CA, USA.
Abstract
OBJECTIVE: To assess the decision-making impairment in patients with multiple sclerosis (MS) and how they relate to other cognitive domains. METHODS: We performed a cross-sectional analysis in 84 patients with MS, and 21 matched healthy controls using four tasks taken from behavioral economics: (1) risk preferences, (2) choice consistency, (3) delay of gratification, and (4) rate of learning. All tasks were conducted using real-world reward outcomes (food or money) in different real-life conditions. Participants underwent cognitive examination using the Brief Repeatable Battery-Neuropsychology. RESULTS: Patients showed higher risk aversion (general propensity to choose the lottery was 0.51 vs 0.64, p = 0.009), a trend to choose more immediate rewards over larger but delayed rewards ( p = 0.108), and had longer reactions times ( p = 0.033). Choice consistency and learning rates were not different between groups. Progressive patients chose slower than relapsing patients. In relation to general cognitive impairments, we found correlations between impaired decision-making and impaired verbal memory ( r = 0.29, p = 0.009), visual memory ( r = -0.37, p = 0.001), and reduced processing speed ( r = -0.32, p = 0.001). Normalized gray matter volume correlated with deliberation time ( r = -0.32, p = 0.005). CONCLUSION: Patients with MS suffer significant decision-making impairments, even at the early stages of the disease, and may affect patients' quality and social life.
OBJECTIVE: To assess the decision-making impairment in patients with multiple sclerosis (MS) and how they relate to other cognitive domains. METHODS: We performed a cross-sectional analysis in 84 patients with MS, and 21 matched healthy controls using four tasks taken from behavioral economics: (1) risk preferences, (2) choice consistency, (3) delay of gratification, and (4) rate of learning. All tasks were conducted using real-world reward outcomes (food or money) in different real-life conditions. Participants underwent cognitive examination using the Brief Repeatable Battery-Neuropsychology. RESULTS:Patients showed higher risk aversion (general propensity to choose the lottery was 0.51 vs 0.64, p = 0.009), a trend to choose more immediate rewards over larger but delayed rewards ( p = 0.108), and had longer reactions times ( p = 0.033). Choice consistency and learning rates were not different between groups. Progressive patients chose slower than relapsing patients. In relation to general cognitive impairments, we found correlations between impaired decision-making and impaired verbal memory ( r = 0.29, p = 0.009), visual memory ( r = -0.37, p = 0.001), and reduced processing speed ( r = -0.32, p = 0.001). Normalized gray matter volume correlated with deliberation time ( r = -0.32, p = 0.005). CONCLUSION:Patients with MS suffer significant decision-making impairments, even at the early stages of the disease, and may affect patients' quality and social life.
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Authors: L Lavorgna; S Esposito; R Lanzillo; M Sparaco; D Ippolito; E Cocco; G Fenu; G Borriello; S De Mercanti; J Frau; R Capuano; F Trojsi; L Rosa; M Clerico; A Laroni; V Brescia Morra; G Tedeschi; S Bonavita Journal: J Neurol Date: 2019-01-16 Impact factor: 4.849