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. 2015 May;86(5):530-6.
doi: 10.1136/jnnp-2014-308169. Epub 2014 Jul 8.

The grey matter correlates of impaired decision-making in multiple sclerosis

Nils Muhlert  1 , Varun Sethi  2 , Lisa Cipolotti  3 , Hamied Haroon  4 , Geoff J M Parker  4 , Tarek Yousry  5 , Claudia Wheeler-Kingshott  2 , David Miller  2 , Maria Ron  2 , Declan Chard  6
Affiliations

The grey matter correlates of impaired decision-making in multiple sclerosis

Nils Muhlert et al. J Neurol Neurosurg Psychiatry. 2015 May.

Abstract

Objective: People with multiple sclerosis (MS) have difficulties with decision-making but it is unclear if this is due to changes in impulsivity, risk taking, deliberation or risk adjustment, and how this relates to brain pathology.

Methods: We assessed these aspects of decision-making in 105 people with MS and 43 healthy controls. We used a novel diffusion MRI method, diffusion orientational complexity (DOC), as an index of grey matter pathology in regions associated with decision-making and also measured grey matter tissue volumes and white matter lesion volumes.

Results: People with MS showed less adjustment to risk and slower decision-making than controls. Moreover, impaired decision-making correlated with reduced executive function, memory and processing speed. Decision-making impairments were most prevalent in people with secondary progressive MS. They were seen in patients with cognitive impairment and those without cognitive impairment. On diffusion MRI, people with MS showed DOC changes in all regions except the occipital cortex, relative to controls. Risk adjustment correlated with DOC in the hippocampi and deliberation time with DOC in the medial prefrontal, middle frontal gyrus, anterior cingulate and caudate parcellations and with white matter lesion volumes.

Conclusions: These data clarify the features of decision-making deficits in MS, and provide the first evidence that they relate to grey and white matter abnormalities seen using MRI.

Keywords: MRI; Multiple Sclerosis.

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Figures

Figure 1
Figure 1
A screenshot from the Cambridge Gambling Task (CGT). In the CGT a token is randomly placed in 1 of 10 coloured boxes. The boxes are either red or blue, and the proportion of each varies between trials. The participant is asked to predict which colour box contains the token, and gamble points on this. For each trial, the amount bet automatically increases or decreases with time until a decision is made.
Figure 2
Figure 2
Parcellations in which associations between decision-making components and diffusion orientational complexity (DOC) changes in patients were found. Deliberation time correlated with DOC in the middle frontal parcellation and showed non-significant trends for correlations with DOC (after correcting for multiple comparisons) in the medial prefrontal, caudate and anterior cingulate parcellations (yellow). DOC in the hippocampus (green) showed a non-significant trend for a correlation with risk adjustment.
See this image and copyright information in PMC

References

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