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The grey matter correlates of impaired decision-making in multiple sclerosis

Muhlert, Nils, Sethi, Varun, Cipolotti, Lisa, Haroon, Hamied, Parker, Geoff J. M., Yousry, Tarek, Wheeler-Kingshott, Claudia, Miller, David, Ron, Maria and Chard, Declan 2014. The grey matter correlates of impaired decision-making in multiple sclerosis. Journal of Neurology, Neurosurgery & Psychiatry 86 (5) , pp. 530-536. 10.1136/jnnp-2014-308169

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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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Additional Information: Pdf uploaded in accordance with the publisher’s policy at (accessed 10/09/2014) and publisher's policy at (accessed 10/09/14)
Publisher: BMJ Publishing Group
ISSN: 0022-3050
Date of First Compliant Deposit: 30 March 2016
Date of Acceptance: 15 June 2014
Last Modified: 04 Jun 2017 06:38

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