Brain activity, regional gray matter loss, and decision-making in multiple sclerosis. (August 2018)

• Record Type: Journal Article
• Authors: Weygandt, Martin; Wakonig, Katharina; Behrens, Janina; Meyer-Arndt, Lil; Söder, Eveline; Brandt, Alexander U; Bellmann-Strobl, Judith; Ruprecht, Klemens; Gold, Stefan M; Haynes, John-Dylan; Paul, Friedemann
• Is Part Of: Multiple sclerosis. Volume 24:Number 9(2018)
• Page Start: 1163
• Page End: 1173
• Publication Date: 2018-08
• Subjects: Multiple sclerosis -- decision-making -- functional magnetic resonance imaging -- Iowa Gambling Task -- brain activity -- gray matter loss; Central nervous system -- Diseases -- Periodicals; Myelin sheath -- Diseases -- Periodicals; Inflammation -- Periodicals; Multiple sclerosis -- Periodicals; Central Nervous System Diseases -- Periodicals; Demyelinating Diseases -- Periodicals; Inflammation -- Periodicals; Multiple Sclerosis -- Periodicals; Système nerveux central -- Maladies -- Périodiques; Gaine de myéline -- Maladies -- Périodiques; Inflammation (Pathologie) -- Périodiques; Sclérose en plaques -- Périodiques; Electronic journals; 616.834005
• DOI: 10.1177/1352458517717089
• Languages: English
• ISSNs: 1352-4585

Abstract

Background: Decision-making (DM) abilities deteriorate with multiple sclerosis (MS) disease progression which impairs everyday life and is thus clinically important. Objective: To investigate the underlying neurocognitive processes and their relation to regional gray matter (GM) loss induced by MS. Methods: We used a functional magnetic resonance imaging (fMRI) Iowa Gambling Task to measure DM-related brain activity in 36 MS patients and 21 healthy controls (HC). From this activity, we determined neural parameters of two cognitive stages, a deliberation ("choice") period preceding a choice and a post-choice ("feedback") stage reporting decision outcomes. These measures were related to DM separately in intact and damaged GM areas as determined by a voxel-based morphometry analysis. Results: Severely affected patients (with high lesion burden) showed worse DM-learning than HC ( t = −1.75, p = 0.045), moderately affected (low lesion burden) did not. Activity in the choice stage in intact insular ( t = 4.60, p Family-Wise Error [FWE] corrected = 0.034), anterior cingulate ( t = 4.50, p FWE = 0.044), and dorsolateral prefrontal areas ( t = 4.43, p FWE = 0.049) and in insular areas with GM loss ( t = 3.78, p FWE = 0.011) was positively linked to DM performance across patients with severe tissue damage and HC. Furthermore, activity in intact orbitofrontal areas was positively linked to DM-learning during the feedback stage across these participants ( t = 4.49, p FWE = 0.032). During none of the stages, moderately affected patients showed higher activity than HC, which might have indicated preserved DM due to compensatory activity. Conclusion: We identified dysregulated activity linked to impairment in specific cognitive stages of reward-related DM. The link of brain activity and impaired DM in areas with MS-induced GM loss suggests that this deficit might be tightly coupled to MS neuropathology.