title: Progressive decline of decision-making performances during multiple sclerosis.
abstract: The purpose of this study was to evaluate longitudinally, using the Iowa Gambling Task (IGT), the dynamics of decision-making capacity at a two-year interval (median: 2.1 years) in a group of patients with multiple sclerosis (MS) (n = 70) and minor neurological disability [Expanded Disability Status Scale (EDSS) < or = 2.5 at baseline]. Cognition (memory, executive functions, attention), behavior, handicap, and perceived health status were also investigated. Standardized change scores [(score at retest-score at baseline)/standard deviation of baseline score] were computed. Results showed that IGT performances decreased from baseline to retest (from 0.3, SD = 0.4 to 0.1, SD = 0.3, p = .005). MS patients who worsened in the IGT were more likely to show a decreased perceived health status and emotional well-being (SEP-59; p = .05 for both). Relapsing rate, disability progression, cognitive, and behavioral changes were not associated with decreased IGT performances. In conclusion, decline in decision making can appear as an isolated deficit in MS.
authors.affiliation: Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
authors.forename: Samanta
authors.initials: S
authors.lastname: Simioni
authors.forename: Christiane
authors.initials: C
authors.lastname: Ruffieux
authors.forename: Joerg
authors.initials: J
authors.lastname: Kleeberg
authors.forename: Laure
authors.initials: L
authors.lastname: Bruggimann
authors.forename: Renaud A
authors.initials: RA
authors.lastname: du Pasquier
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Annoni
authors.forename: Myriam
authors.initials: M
authors.lastname: Schluep
mesh_terms: D000328:Adult; D003657:Decision Making / Q000502:physiology*; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology*; D009483:Neuropsychological Tests; D055815:Young Adult