The objective of this study was to test a new version of the Magnetic Resonance Disease Severity Scale (MRDSS2), incorporating cerebral gray matter (GM) and spinal cord involvement from 3 T MRI, in modeling the relationship between MRI and physical disability or cognitive status in multiple sclerosis (MS). Fifty-five MS patients and 30 normal controls underwent high-resolution 3 T MRI. The patients had an Expanded Disability Status Scale score of 1.6±1.7 (mean±SD). The cerebral normalized GM fraction (GMF), the T2 lesion volume (T2LV), and the ratio of T1 hypointense LV to T2LV (T1/T2) were derived from brain images. Upper cervical spinal cord area (UCCA) was obtained from spinal cord images. A within-subject d-score (difference of MS from normal control) for each MRI component was calculated, equally weighted, and summed to form MRDSS2. With regard to the relationship between physical disability and MRDSS2 or its individual components, MRI–Expanded Disability Status Scale correlations were significant for MRDSS2 (r=0.33, P=0.013) and UCCA (r=−0.33, P=0.015), but not for GMF (P=0.198), T2LV (P=0.707), and T1/T2 (P=0.240). The inclusion of UCCA appeared to drive this MRI–disability relationship in MRDSS2. With regard to cognition, MRDSS2 showed a larger effect size (P=0.035) than its individual components [GMF (P=0.081), T2LV (P=0. 179), T1/T2 (P=0.043), and UCCA (P=0.818)] in comparing cognitively impaired with cognitively preserved patients (defined by the Minimal Assessment of Cognitive Function in MS). Both cerebral lesions (T1/T2) and atrophy (GMF) appeared to drive this relationship. We describe a new version of the MRDSS, which has been expanded to include cerebral GM and spinal cord involvement. MRDSS2 has concurrent validity with clinical status.
Valence is a principal dimension by which we understand emotional experiences, but oftentimes events are not easily classified as strictly positive or negative. Inevitably, individuals vary in how they tend to interpret the valence of ambiguous situations. Surprised facial expressions are one example of a well-defined, ambiguous affective event that induces trait-like differences in the propensity to form a positive or negative interpretation. To investigate the nature of this affective bias, we asked participants to organize emotional facial expressions (surprised, happy, sad) into positive/negative categories while recording their hand-movement trajectories en route to each response choice. We found that positivity-negativity bias resulted in differential hand movements for modal versus non-modal response trajectories, such that when an individual categorized a surprised face according to his or her non-modal interpretation (e.g., a negatively biased individual selecting a positive interpretation), the hand showed an enhanced spatial attraction to the alternative, modal response option (e.g., negative) in the opposite corner of the computer screen (Experiment 1). Critically, we also demonstrate that this asymmetry between modal versus non-modal response trajectories is mitigated when the valence interpretations are made under a cognitive load, although the frequency of modal interpretations is unaffected by the load (Experiment 2). These data inform a body of seemingly disparate findings regarding the effect of cognitive effort on affective responses, by showing within a single paradigm that varying cognitive load selectively alters the dynamic motor movements involved in indicating affective interpretations, whereas the interpretations themselves remain consistent across variable cognitive loads.
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