Preserved decision making ability in early multiple sclerosis

Simioni, Samanta; Ruffieux, Christiane; Kleeberg, Joerg; Bruggimann, Laure; Annoni, Jean‐Marie; Schluep, Myriam

doi:10.1007/s00415-008-0025-5

Cited by 29 publications

(41 citation statements)

References 37 publications

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“…While DM can be preserved in very early RRMS patients [15], we found by means of a two-year follow-up study that such abilities rapidly declined over time, independently of other disease-evolution markers [7]. All these results underscore the fact that MS patients may fail in choosing advantageously when confronted with ambiguous situations.…”

Section: Introductionmentioning

confidence: 51%

Multiple Sclerosis Decreases Explicit Counterfactual Processing and Risk Taking in Decision Making

et al. 2012

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IntroductionDeficits in decision making (DM) are commonly associated with prefrontal cortical damage, but may occur with multiple sclerosis (MS). There are no data concerning the impact of MS on tasks evaluating DM under explicit risk, where different emotional and cognitive components can be distinguished.MethodsWe assessed 72 relapsing-remitting MS (RRMS) patients with mild to moderate disease and 38 healthy controls in two DM tasks involving risk with explicit rules: (1) The Wheel of Fortune (WOF), which probes the anticipated affects of decisions outcomes on future choices; and (2) The Cambridge Gamble Task (CGT) which measures risk taking. Participants also underwent a neuropsychological and emotional assessment, and skin conductance responses (SCRs) were recorded.ResultsIn the WOF, RRMS patients showed deficits in integrating positive counterfactual information (p<0.005) and greater risk aversion (p<0.001). They reported less negative affect than controls (disappointment: p = 0.007; regret: p = 0.01), although their implicit emotional reactions as measured by post-choice SCRs did not differ. In the CGT, RRMS patients differed from controls in quality of DM (p = 0.01) and deliberation time (p = 0.0002), the latter difference being correlated with attention scores. Such changes did not result in overall decreases in performance (total gains).ConclusionsThe quality of DM under risk was modified by MS in both tasks. The reduction in the expression of disappointment coexisted with an increased risk aversion in the WOF and alexithymia features. These concomitant emotional alterations may have implications for better understanding the components of explicit DM and for the clinical support of MS patients.

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Section: Introductionmentioning

confidence: 51%

Multiple Sclerosis Decreases Explicit Counterfactual Processing and Risk Taking in Decision Making

et al. 2012

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“…This approach has yielded marginal or non-significant results. For example, comparing multiple sclerosis patients with normal or weak decision-making ability, the difference in total score on a French version of the ISPC (Juillerat, Peter-Favre, & Van der Linden, 1998) was not significant (Simioni et al, 2008). In a second study, patients with multiple sclerosis did not differ from controls in total ISPC score, although there were differences in particular characteristics such as lack of stamina, inflexibility, social withdrawal and lack of insight (Souza Lima et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…The ISPC has shown sensitivity to personality changes in patients with Parkinson's disease (Gronchi-Perrin et al, 2007; Houeto et al, 2002, 2006; Witjas et al, 2005), frontotemporal dementia (Hallam, MacKenzie, & Feldman, 2006), multiple sclerosis (Simioni et al, 2008, 2009; Souza Lima et al, 2007), brain cancer (Gleason, 2004), traumatic brain injury (Cantagallo, Contini, & Bianchi, 2010; Rochat, Ammann, Mayer, Annoni, & Van der Linden, 2009), focal vmPFC lesions (Driscoll, 2009; Koenigs et al, 2007; Tranel, Damasio, Denburg, & Bechara, 2005; Young et al, 2010), focal posterior lesions from stroke (Annoni, Devuyst, Carota, Bruggimann, & Bogousslavsky, 2005; Hommel et al, 2000), and temporal lobectomy (Sellal et al, 2003; Tranel & Bechara, 2009). However, the factor structure of the ISPC has not been investigated.…”

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confidence: 99%

Dimensions of personality disturbance after focal brain damage: Investigation with the Iowa Scales of Personality Change

Barrash

Asp

Markon

et al. 2011

Journal of Clinical and Experimental Neuropsychology

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This study employed a multi-step, rational-empirical approach to identify dimensions of personality disturbance in brain-damaged individuals: (1) Five dimensions were hypothesized based on empirical literature and conceptual grounds. (2) Principal components analysis was performed on the Iowa Scales of Personality Change to determine the pattern of covariance among 30 personality characteristics. (3) When discrepancies existed between principal components analysis results and conceptually-based dimensions, empirical findings and clinical considerations were weighed to determine assignment of ISPC scales to dimensions. (4) The fit of data to the refined dimensions was assessed by examination of intercorrelations. (5) Differential predictions concerning the relationship of dimensions to ventromedial prefrontal (vmPFC) damage were tested. This process resulted in specification of five dimensions: Disturbed Social Behavior, Executive/Decision-Making Deficits, Diminished Motivation/Hypo-emotionality, Irascibility, and Distress. In accord with predictions, the 28 participants with vmPFC lesions, compared to 96 participants with focal lesions elsewhere in the brain, had significantly more Disturbed Social Behavior and Executive/Decision-Making Deficits, and tended to have more Diminished Motivation/Hypo-emotionality. Irascibility was not significantly higher among the vmPFC group, and the groups had very similar levels of Distress. The findings indicate that conceptually distinctive dimensions with differential relationships to vmPFC can be derived from the Iowa Scales of Personality Change. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptPersonality disturbances are common in individuals with brain dysfunction from a variety of etiologies, including traumatic brain injury (TBI) (Dywan & Segalowitz, 1996;Eslinger, Grattan, & Geder, 1996;Levin et al., 1987;Lezak, 1987), frontotemporal dementia (Kertesz, Nadkarni, Davidson, & Thomas, 2000;Malloy, Tremont, Grace, & Frakey, 2007;Miller, Darby, Benson, Cummings, & Miller, 1997), Huntington's disease (Cummings & Cunningham, 1992;Folstein, 1989), Alzheimer's disease (Malloy et al., 2007;Reisberg et al., 1987), Parkinson's disease (Kaasinen et al., 2001;Menza, 2000), epilepsy (Devinsky, 1991;Hermann, Wyler & Richey, 1987), brain tumors (Gleason, 2004Hunter, Blackwood, & Bull, 1968), and stroke (DeLuca & Diamond, 1995). Indeed, personality disturbances following brain damage can be devastating, and in regard to psychosocial functioning in particular, can have more profound impact than acquired cognitive impairments (Lezak, 1987;Nightingale, Soo, & Tate, 2007). In this paper, the term "personality" refers broadly to enduring behavioral tendencies, with "behavior" explicitly including characteristic tendencies of drive, affect and mood; pervasive attitudes and self-awareness; and cognitive tendencies which, if disturbed, adversely impact the individual's interpersonal or psychosocial functioning (Stuss, Gow, & Hetherington, 1992). In regards to a...

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“…Specifically, executive functions such as working memory, problem solving, abstract reasoning, planning, and inhibitory control, are often impaired (Arnett et al, 1997;Foong et al, 1997). Several behavioral studies using the IGT have reported DM impairment in patients with MS (Nagy et al, 2006;Roca et al, 2008;Simioni et al, 2008Simioni et al, , 2009Garc ıa-Molina et al, 2009). The execution of the IGT by patients with MS is characterized by a marked tendency to make unfavorable choices in comparison to healthy control subjects (Kleeberg et al, 2004;Nagy et al, 2006;Roca et al, 2008;Garc ıa-Molina et al, 2009;Simioni et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological correlates of decision making impairment in multiple sclerosis

Azcárraga-Guirola

Rodríguez-Agudelo

Velázquez-Cardoso

et al. 2016

Eur J of Neuroscience

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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.

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Preserved decision making ability in early multiple sclerosis

Cited by 29 publications

References 37 publications

Multiple Sclerosis Decreases Explicit Counterfactual Processing and Risk Taking in Decision Making

Multiple Sclerosis Decreases Explicit Counterfactual Processing and Risk Taking in Decision Making

Dimensions of personality disturbance after focal brain damage: Investigation with the Iowa Scales of Personality Change

Electrophysiological correlates of decision making impairment in multiple sclerosis

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