RT Journal Article
SR Electronic
T1 The grey matter correlates of impaired decision-making in multiple sclerosis
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 530
OP 536
DO 10.1136/jnnp-2014-308169
VO 86
IS 5
A1 Muhlert, Nils
A1 Sethi, Varun
A1 Cipolotti, Lisa
A1 Haroon, Hamied
A1 Parker, Geoff J M
A1 Yousry, Tarek
A1 Wheeler-Kingshott, Claudia
A1 Miller, David
A1 Ron, Maria
A1 Chard, Declan
YR 2015
UL http://jnnp.bmj.com/content/86/5/530.abstract
AB 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.