Background: Scattered, previous literature data (Kleeber et al 2006, Nagy et al 2004) suggest that decision making ability is impaired in patients with Multiple Sclerosis (MS). In the present study we evaluated whether young, high functioning patients with MS and no significant cognitive impairment display problems in taking effective decisions in a gambling task that simulates real-life decision making. Methods: Twenty-nine consecutive relapsing-remitting MS patients fulfilling McDonald criteria and 30 matched healthy volunteers were included into the study. Patients were selected basing on their performance at an extensive neuropsychological battery: those who obtained an abnormal score in more than one test were excluded. All participants underwent the computerized Iowa Gambling Task (IGT), which requires the subject to gain money by choosing from four decks of cards with different arrangements of rewards and penalties. Test parameter is the number of advantageous choices computed for all 100 trials and for five consecutive blocks of 20 trials each. Results: Patient and control groups were comparable with respect to socio-demographic features. IGT total score was significantly better for controls (mean ±SEM) (16.9 ±3.3) than for MS subjects (-0.3 ±2.8) (p=0.000). A 2 (group) X 5 (block) ANOVA revealed a significant effect for block [F(4, 228)= 5.539, p= 0.001] and for group [F(1, 57)= 15.521, p= 0.000] and a strong trend towards significance for group by block interaction [F(4, 228)= 2.559, p= 0.053]. Discussion: Unlike normal controls, MS patients showed no increase in the number of advantageous choices throughout the IGT, suggesting that decision making ability may be selectively and significantly poor in otherwise unimpaired multiple sclerosis subjects. These findings may have implications for the clinical management of these patients and for the understanding of the neural and neuropsychological correlates of decision making ability
Mapelli, C., Rota, S., Isella, V., Appollonio, I. (2008). Decision making impairment in high-functioning multiple sclerosis patients. Intervento presentato a: First Meeting of the Federation of the European Societies of Neuropsychology, Edinburgh.
Decision making impairment in high-functioning multiple sclerosis patients
MAPELLI, CRISTINA;ROTA, STEFANIA;ISELLA, VALERIA;APPOLLONIO, ILDEBRANDO
2008
Abstract
Background: Scattered, previous literature data (Kleeber et al 2006, Nagy et al 2004) suggest that decision making ability is impaired in patients with Multiple Sclerosis (MS). In the present study we evaluated whether young, high functioning patients with MS and no significant cognitive impairment display problems in taking effective decisions in a gambling task that simulates real-life decision making. Methods: Twenty-nine consecutive relapsing-remitting MS patients fulfilling McDonald criteria and 30 matched healthy volunteers were included into the study. Patients were selected basing on their performance at an extensive neuropsychological battery: those who obtained an abnormal score in more than one test were excluded. All participants underwent the computerized Iowa Gambling Task (IGT), which requires the subject to gain money by choosing from four decks of cards with different arrangements of rewards and penalties. Test parameter is the number of advantageous choices computed for all 100 trials and for five consecutive blocks of 20 trials each. Results: Patient and control groups were comparable with respect to socio-demographic features. IGT total score was significantly better for controls (mean ±SEM) (16.9 ±3.3) than for MS subjects (-0.3 ±2.8) (p=0.000). A 2 (group) X 5 (block) ANOVA revealed a significant effect for block [F(4, 228)= 5.539, p= 0.001] and for group [F(1, 57)= 15.521, p= 0.000] and a strong trend towards significance for group by block interaction [F(4, 228)= 2.559, p= 0.053]. Discussion: Unlike normal controls, MS patients showed no increase in the number of advantageous choices throughout the IGT, suggesting that decision making ability may be selectively and significantly poor in otherwise unimpaired multiple sclerosis subjects. These findings may have implications for the clinical management of these patients and for the understanding of the neural and neuropsychological correlates of decision making ability
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
