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Online Repetitive Transcranial Magnetic Stimulation of Dorsomedial and Dorsolateral Prefrontal Cortex in Cognition Decision Making, and Cognitive Dissonance

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Multiple sclerosis decreases explicit counterfactual processing and risk taking in decision making.

Samanta Simioni¹, Myriam Schluep, Nadège Bault

¹Department of Clinical Neurosciences, University Hospital and University of Lausanne, Lausanne, Switzerland.

|December 11, 2012

Summary

Multiple sclerosis (MS) patients exhibit altered decision-making (DM) under risk, showing increased risk aversion and reduced emotional responses. These findings highlight emotional and cognitive changes impacting MS patient support.

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Area of Science:

Neuroscience
Psychology
Clinical Medicine

Background:

Decision-making (DM) deficits are linked to prefrontal damage and may occur in multiple sclerosis (MS).
Limited data exist on how MS affects DM tasks involving explicit risk and emotional/cognitive components.

Purpose of the Study:

To investigate the impact of MS on DM tasks assessing risk-taking and emotional responses.
To evaluate DM under explicit risk in relapsing-remitting MS (RRMS) patients compared to healthy controls.

Main Methods:

Assessed 72 RRMS patients and 38 controls using the Wheel of Fortune (WOF) and Cambridge Gamble Task (CGT).
Administered neuropsychological and emotional assessments, recording skin conductance responses (SCRs).

Main Results:

RRMS patients showed impaired positive counterfactual integration and increased risk aversion in the WOF.
Patients reported less disappointment and regret, despite similar SCRs, and exhibited altered DM quality and longer deliberation times in the CGT.
No overall decrease in performance (total gains) was observed in RRMS patients.

Conclusions:

MS modifies the quality of DM under risk, characterized by increased risk aversion and reduced disappointment expression.
Concomitant emotional alterations, including alexithymia features, may influence explicit DM in MS.
Findings offer insights into explicit DM components and inform clinical support for MS patients.