Impairment in oral medical comprehension in multiple sclerosis

In multiple sclerosis (MS), medical comprehension of website information and informed consent is reported to be impaired. The aim of the present study was to investigate oral medical comprehension of literal, figurative and humorous language in MS through videos of physician-patient exchanges. A group of 35 MS patients was compared to a control group (38 healthy participants). Participants were shown twelve filmed sketches consisting of a patient's question followed by the doctor's response and had to choose the meaning of the physician's response among three possibilities. Group analyses (non-parametric tests, Mann-Whitney) revealed significantly lower scores for MS patients compared to controls for figurative and humorous items. The opposite was observed for literal items. At the individual level, 17% of MS patients were impaired in their comprehension of figurative items and 32% for humorous items. Among them, 20% were impaired in both categories, 20% selectively in figurative comprehension and 60% selectively in humorous comprehension. These preliminary results suggest that a high proportion of MS patients (40%) may be impaired in the non-literal comprehension of simple medical responses. The better performances obtained for literal items suggest a more concrete linguistic decoding in MS. On a theoretical level, the double dissociations shown between figurative and humorous items in patients are not compatible with a serial model of linguistic processing.