Decision-making impairment in patients with multiple sclerosis: a case-control study.
Bottom Line: Patients with MS showed significantly poorer performance on the Game of Dice Task, choosing disadvantageous dice more often (p=0.019), as well as significantly lower overall scores in the Iowa Gambling Task (p=0.007).Block analysis showed that patients with MS and controls had scores that were comparable for blocks 1 and 2 (p=0.15 and p=0.24, respectively).Finally, the Game of Dice Task performance together with the last three blocks of the Iowa Gambling Task were correlated with visuospatial learning, processing speed and working memory but not with executive functioning.
Affiliation: Department of Neurology, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina.Show MeSH
Related in: MedlinePlus
Mentions: IGT differs from GDT essentially in that outcome probabilities are unknown and participants have to learn which options are advantageous. Throughout the 100 test trials, patients with MS chose less advantageous decks significantly more often, as reflected by lower total IGT scores (32.9±4.1 for HC vs 14.9±4.9 for patients with MS, p=0.007; see figure 2A). It has been argued that IGT actually assesses DM in a dual fashion.13 The first two blocks truly correspond to decisions made under ambiguity, as individuals follow their guesses and hunches to choose between decks. However, once participants figure out which decks are associated with worse outcomes, they learn to choose the better decks so that, for the last three blocks, decisions are made based on relatively known risks,1333 in which executive control is thought to play a more important role.14
Affiliation: Department of Neurology, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina.