Neural mechanisms of perceptual decision-making and their link to neuropsychiatric symptoms in multiple sclerosis

Item Type:	Article
Title:	Neural mechanisms of perceptual decision-making and their link to neuropsychiatric symptoms in multiple sclerosis
Creators Name:	Weygandt, M. and Behrens, J. and Brasanac, J. and Söder, E. and Meyer-Arndt, L. and Wakonig, K. and Ritter, K. and Brandt, A.U. and Bellmann-Strobl, J. and Gold, S.M. and Haynes, J.D. and Paul, F.
Abstract:	BACKGROUND: Decision-making (DM) capabilities are impaired in multiple sclerosis (MS). A variety of researchers hypothesized that this impairment is associated with reduced quality of life (QoL) and neuropsychiatric symptoms. Studies explicitly testing this hypothesis, however, are rare, provided inconclusive results, or evaluated only a limited selection of DM domains. Consequently, we conducted the first MS study on perceptual DM (e.g. deciding whether a car will fit into a parking lot based on a visual percept) to test this assumption. METHODS: Specifically, we used an fMRI task that measured brain activity in 30 MS patients and 19 healthy controls (HCs) while the participants repeatedly decided whether objects referenced indirectly via their written object names would fit into a shoebox to investigate neural mechanisms of perceptual DM. The objects varied in size and thus decision difficulty. From these data, we determined voxel-wise brain activity parameters reflecting (i) decision difficulty and (ii) decision speed and related them to behavioral DM performance, QoL, mild to moderate depressive symptoms, and fatigue. RESULTS: Patients showed reduced DM performance. Activity reflecting decision difficulty in the middle temporal gyrus was negatively related to DM performance across MS patients and HCs; activity reflecting decision speed in MS patients was associated with depressive symptoms and fatigue in areas of the dorsal visual stream. CONCLUSION: The study shows that the perceptual DM capacity is reduced in MS. Moreover, the link between neural mechanisms of perceptual DM and neuropsychiatric symptoms suggests that an impairment in this domain is clinically relevant.
Keywords:	Multiple Sclerosis, Perceptual Decision-Making, Neuropsychiatric Symptoms, Task-Based fMRI
Source:	Multiple Sclerosis and Related Disorders
ISSN:	2211-0348
Publisher:	Elsevier
Volume:	33
Page Range:	139-145
Date:	August 2019
Official Publication:	https://doi.org/10.1016/j.msard.2019.05.025
PubMed:	View item in PubMed

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