Electrophysiological correlates of decision making impairment in multiple sclerosis

Abstract

Although previous studies have shown that patients with multiple sclerosis (MS) may exhibit impaired decision making (DM), the specific neuro-cognitive processes that underlie this deficiency remain unknown. Inefficient DM may occur due to poor option assessment or a deficit in the evaluation of choice outcomes. This study uses, for the first time, the event-related potential (ERP) technique to analyze these DM subprocesses in patients with MS. Sixteen MS patients and nineteen control subjects performed a DM task based on the Iowa Gambling Task while a digital EEG was recorded. The P3b was analyzed as an index of option assessment, and both the feedback-related negativity (FRN) and P3b were considered markers for choice outcome evaluation. We found that MS patients made a larger number of unfavorable choices during the DM task (P = 0.02), with no differences between groups for reaction times. There were no significant differences in P3b for option assessment between the groups. In the control group, the type of feedback (gain, loss, or nothing) modified the FRN (F = 3.72, P = 0.033) and the P3b (F = 3.15, P = 0.059). This effect was not observed in the MS group. Also, FRN latencies were shorter in the MS group compared to controls (P = 0.047). Finally, lesions in temporal regions revealed by MRI were associated with DM both in behavioral and electrophysiological terms. We conclude that the DM impairment of patients with MS may be due to a deficit in their evaluation of choice outcomes or a general alteration in emotional reactivity.

Decision-making in primary onset middle-age type 2 diabetes mellitus: a BOLD-fMRI study

“…More recently, researches show that deficit in decision-making is independent of other cognitive changes occurring during the same period 10 , 40 . Consistent with previous studies 19 , 38 , 39 , we did not find any correlation between impaired decision-making in T2DM group and general cognitive impairment, as measured by the MOCA and MMSE. Further studies are needed to address the potential cognitive factor affecting the decisional process in T2DM group.…”

“…Previously it was found that decline in general cognitive function may lead to increased difficulty in decision-making in Alzheimer’s disease patients 12 . However, the majority of IGT studies have failed to observe this association in other populations 19 , 38 , 39 . More recently, researches show that deficit in decision-making is independent of other cognitive changes occurring during the same period 10 , 40 .…”

“…Then, MOCA total scores were significantly lower for the T2DM group, indicating that T2DM patients possibly have general cognitive impairment. In other investigation studying decision-making, they also have some patients with general cognitive impairment 17 , 19 . Nevertheless, it may be more convincing to determine cognitive impairment through a comprehensive neuropsychological battery of standard tests.…”

Temperature sensitivity in multiple sclerosis: An overview of its impact on sensory and cognitive symptoms

“…retrieve and identify information from past memories) [77,78] and in the ability to retain old memories [81,82]. Furthermore, deficits in attention [79,80], information processing, decision making and problem solving [81,83,84] especially during multitasking activities [85], seem to be frequent. Finally, language and verbal fluency are often impaired in MS [75] and these defects manifest in slow speech capacity and slow information processing speed [74].…”

The Agony of Choice? Preserved Affective Decision Making in Early Multiple Sclerosis

“…Secondly, previous studies only evaluated the accuracy measures of the IGT (e.g., total earned money) and neglected other measures that could provide a deeper insight into the processing of affective feedback (e.g., reaction times following winning or losing trials). Finally, most available studies on DM ability in MS employed clinically heterogeneous samples with regard to disease severity and disease course ( 17 , 23 , 24 ). This is particularly problematic given that the rates of CI differ remarkably between relapsing-remitting and progressive disease courses, which may also influence DM performance ( 25 ).…”