The grey matter correlates of impaired decision-making in multiple sclerosis.
The grey matter correlates of impaired decision-making in multiple sclerosis.
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DOI：
10.1136/jnnp-2014-308169
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发表时间：
2015-05
期刊：
影响因子：
--
通讯作者：
Chard D
中科院分区：
文献类型：
--
作者：
Muhlert N;Sethi V;Cipolotti L;Haroon H;Parker GJ;Yousry T;Wheeler-Kingshott C;Miller D;Ron M;Chard D
多发性硬化症（MS）患者在决策方面有困难，但目前尚不清楚这是否是由于冲动，冒险，深思熟虑或风险调整的变化，以及这与大脑病理学的关系。我们在105名MS患者和43名健康对照者中评估了这些决策方面。我们使用了一种新的扩散MRI方法，扩散方向复杂性（DOC），作为与决策相关的区域的灰质病理学指标，并测量了灰质组织体积和白色病变体积。与对照组相比，MS患者对风险的调整较少，决策较慢。此外，决策能力受损与执行功能、记忆力和处理速度下降有关。决策障碍在继发性进行性MS患者中最常见，见于认知障碍患者和无认知障碍患者。在扩散MRI上，MS患者与对照组相比，除了枕叶皮质外，所有区域都显示DOC变化。风险调整与DOC在大脑前额叶，额中回，前扣带回和尾状核包裹DOC和白色病变体积的审议时间。这些数据阐明了MS决策缺陷的特征，并提供了第一个证据表明它们与使用MRI观察到的灰质和白色异常有关。
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. 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. 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. 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.
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影响因子：
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