Impairment of decision-making in multiple sclerosis: A neuroeconomic approach.
OBJECTIVE
To assess the decision-making impairment in patients with multiple sclerosis (MS) and how they relate to other cognitive domains.


METHODS
We performed a cross-sectional analysis in 84 patients with MS, and 21 matched healthy controls using four tasks taken from behavioral economics: (1) risk preferences, (2) choice consistency, (3) delay of gratification, and (4) rate of learning. All tasks were conducted using real-world reward outcomes (food or money) in different real-life conditions. Participants underwent cognitive examination using the Brief Repeatable Battery-Neuropsychology.


RESULTS
Patients showed higher risk aversion (general propensity to choose the lottery was 0.51 vs 0.64, p = 0.009), a trend to choose more immediate rewards over larger but delayed rewards ( p = 0.108), and had longer reactions times ( p = 0.033). Choice consistency and learning rates were not different between groups. Progressive patients chose slower than relapsing patients. In relation to general cognitive impairments, we found correlations between impaired decision-making and impaired verbal memory ( r = 0.29, p = 0.009), visual memory ( r = -0.37, p = 0.001), and reduced processing speed ( r = -0.32, p = 0.001). Normalized gray matter volume correlated with deliberation time ( r = -0.32, p = 0.005).


CONCLUSION
Patients with MS suffer significant decision-making impairments, even at the early stages of the disease, and may affect patients' quality and social life.
['Sepúlveda|Maria|M|', 'Fernández-Diez|Begoña|B|', 'Martínez-Lapiscina|Elena H|EH|', 'Llufriu|Sara|S|', 'Sola-Valls|Nuria|N|', 'Zubizarreta|Irati|I|', 'Blanco|Yolanda|Y|', 'Saiz|Albert|A|', 'Levy|Dino|D|', 'Glimcher|Paul|P|', 'Villoslada|Pablo|P|']
D000328:Adult D002755:Choice Behavior D060825:Cognitive Dysfunction D003430:Cross-Sectional Studies D003657:Decision Making D065786:Delay Discounting D060909:Economics, Behavioral D005260:Female D006801:Humans D007858:Learning D008297:Male D008875:Middle Aged D009103:Multiple Sclerosis D012309:Risk-Taking
decision-making Multiple sclerosis neuroeconomics cognitive impairment