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Progressive decline of decision-making performances during multiple sclerosis

Published online by Cambridge University Press:  01 March 2009

SAMANTA SIMIONI
Affiliation:
Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
CHRISTIANE RUFFIEUX
Affiliation:
Department of Social and Preventive Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
JOERG KLEEBERG
Affiliation:
Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
LAURE BRUGGIMANN
Affiliation:
Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
RENAUD A. DU PASQUIER
Affiliation:
Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland Department of Immunology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
JEAN-MARIE ANNONI
Affiliation:
Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland Department of Neurology, Geneva University Hospital, Switzerland.
MYRIAM SCHLUEP*
Affiliation:
Department of Neurology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
*
*Correspondence and reprint requests to: Dr. Myriam Schluep, Department of Neurology BH07, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland. E-mail: Myriam.Schluep@chuv.ch.

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) ≤ 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. (JINS, 2009, 15, 291–295.)

Type
Brief Communications
Copyright
Copyright © INS 2009

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