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Updated: Feb 27, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Brain activity, regional gray matter loss, and decision-making in multiple sclerosis
Martin Weygandt1, Katharina Wakonig2, Janina Behrens3
1Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Excellence Cluster NeuroCure; 10117 Berlin, Germany / Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Berlin Center for Advanced Neuroimaging, Department of Neurology; 10117 Berlin, Germany / Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Bernstein Center for Computational Neuroscience; 10117 Berlin, Germany.
Decision-making abilities decline in multiple sclerosis (MS) patients with severe disease, linked to brain activity changes in specific cognitive stages. This impairment may be tied to MS-related gray matter loss.
Area of Science:
- Neuroscience
- Cognitive Science
- Medical Imaging
Background:
- Decision-making (DM) abilities are crucial for daily functioning and often decline with multiple sclerosis (MS) progression.
- Understanding these cognitive deficits is clinically significant for managing MS.
Purpose of the Study:
- To investigate the neurocognitive processes underlying impaired DM in MS.
- To examine the relationship between DM deficits and regional gray matter (GM) loss in MS patients.
Main Methods:
- Functional magnetic resonance imaging (fMRI) and the Iowa Gambling Task were used to assess DM-related brain activity in 36 MS patients and 21 healthy controls (HC).
- Neural parameters for "choice" (deliberation) and "feedback" (outcome) stages were analyzed.
- Voxel-based morphometry identified intact and damaged GM areas, correlating them with DM performance.
Main Results:
- Severely affected MS patients exhibited poorer DM learning compared to HC (p=0.045).
- Brain activity in intact insular, anterior cingulate, and dorsolateral prefrontal areas during the choice stage, and in intact orbitofrontal areas during the feedback stage, positively correlated with DM performance in severely affected patients and HC.
- Activity in insular areas with GM loss also linked to DM performance in this group.
Conclusions:
- Dysregulated brain activity in specific cognitive stages of reward-related DM was identified in MS patients.
- The correlation between brain activity, impaired DM, and MS-induced GM loss suggests a strong link between neuropathology and cognitive deficits.
