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

Abstract:

BACKGROUND:Decision-making is an essential function of everyday life. Decision-making under explicit risk requires developing advantageous decision strategies based on fixed outcomes (e.g., probabilities of winning or losing a bet). Decision-making and its neural substrates have been rarely studied in MS. We expected performance in decision-making under risk to be lowered in MS patients, and negatively correlated with disease-related disability, cognition, and ventricular width. METHODS:Three groups were included: 32 MS patients and 20 healthy controls were examined with conventional neuropsychological tests and the Game-of-Dice Task (GDT) assessing decision-making under explicit risk. Linear 2-D ventricular width was assessed on MS patients' clinical MRIs and compared to a third group, 20 non-MS neurological control patients. RESULTS:Compared to healthy controls, MS patients showed impaired GDT and neuropsychological performance, depending on the MS-subtype (relapsing-remitting (RR), n = 22; secondary progressive, n = 10) and disability severity among RR-MS patients. In MS patients, GDT performance correlated with processing speed, intercaudate ratio, and third ventricle ratio (p's < 0.05). Mediation analysis showed that the link between GDT performance and processing speed was fully explained by ventricular size. CONCLUSION:Decision-making under explicit risk was reduced in MS patients, but only those with more pronounced disability. Independent of processing speed, decision-making under explicit risk correlates inversely with central atrophy in MS.

journal_name

BMC Neurol

journal_title

BMC neurology

authors

Radomski AD,Power C,Purdon SE,Emery DJ,Blevins G,Warren KG,Fujiwara E

doi

10.1186/s12883-015-0318-0

subject

Has Abstract

pub_date

2015-04-23 00:00:00

pages

61

issn

1471-2377

pii

10.1186/s12883-015-0318-0

journal_volume

15

pub_type

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