How's YOUR decision-making?

[SuzE-Q]

Looks like high-functioning mild MSer's are fine at decision-making, albeit at a slower rate.

lol. I THINK I read that right.

J Clin Exp Neuropsychol.
2014 Dec 8:1-10. [Epub ahead of print]

Cognitive correlates of under-ambiguity and under-risk decision making in high-functioning patients with relapsing remitting multiple sclerosis.

Cogo MG1, Rota S, Fusco ML, Mapelli C, Ferri F, Appollonio IM, Isella V.


Abstract

Introduction: Impairment of decision making in relapsing remitting multiple sclerosis is still controversial, and its neuropsychological correlates have never been explored thoroughly, especially in patients with minimal physical and cognitive deficits. In the present study we investigated the cognitive underpinnings of decision making under ambiguous and explicit conditions in patients with very mild relapsing remitting multiple sclerosis, using a dice and a card gambling game.

Method: The study sample included 60 patients and 35 healthy subjects. In the Game of Dice Task, winning and losing probabilities are obvious to the subject, while in the Iowa Gambling Task they are initially ambiguous and have to be gradually identified. Performance at the two tasks was correlated with scores obtained at tests investigating cognitive processing speed, memory, language and executive functions.

Results: Patients' performance did not differ from that of controls at either gambling task. There was only a trend for them to be significantly slower than healthy subjects in progressively recognizing advantageous decks in the Iowa Gambling Task. While the Game of Dice was unrelated to neuropsychological tests, predictors of performance at the Iowa task were Letter Fluency and the Symbol Digit Modalities Test for the initial, under-ambiguity, trials and the Wisconsin Card Sorting Test for the last, purely under-risk, trials.

Conclusions: Our results suggest that high-functioning patients with relapsing remitting multiple sclerosis are substantially capable of making advantageous decisions, even if they may be slower in processing options and shifting strategy when selection criteria are not explicit.


KEYWORDS:
Decision making; Executive functions; Game of Dice Task; Iowa Gambling Task; Multiple sclerosis
PMID: 25486588 [PubMed - as supplied by publisher]

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[Parsi]

Decision making? What's that? I find it so hard to decide on something. It's worse as I dwell on a problem or the day goes on.
But then there are times when I have no problem at all.

There's one key word in the study: patients with MINIMAL physical and cognitive deficits.
There are MSers out there doing fine in the work place in jobs that require decision making. But I would not be able to handle it 8 hours a day, 5 days a week, week after week.

[SalpalSally]

I've had MS since my early 20s and maybe earlier. I don't remember ever
having a hard time making important decisions and still don't. Although I
am now, in the "I don't shiv a git" part of my life and am sooooo glad, not
to have to make the life changing decisions anymore.. I did retire, though,
before my MS progressed to SPMS.

[SuzE-Q]

I've had MS since my early 20s and maybe earlier. I don't remember ever
having a hard time making important decisions and still don't. Although I
am now, in the "I don't shiv a git" part of my life and am sooooo glad, not
to have to make the life changing decisions anymore.. I did retire, though,
before my MS progressed to SPMS.

How long into your MS did it turn to SPMS, Sally? And would you rather have the more dramatic fluctuations of RRMS but at least with a little remission, or the slower, but unfortunately more progressive and permanent SPMS?

[Howie]

I don't even know what I am classified as now. I've only seen a Neuro once to get DXed, and 15 years later I still don't have a Neuro.

[SuzE-Q]

I don't even know what I am classified as now. I've only seen a Neuro once to get DXed, and 15 years later I still don't have a Neuro.

Sounds like you are SPMS if you had a couple attacks initially, then slow progression with no further identifiable attacks since then. That would be my guess.

[Gary]

I take much more time to make decisions due to the MS and getting older as well. I know my cognitive part of the brain just doesn't work as fast. For those really important one I get other peoples input. I know my thought process isn't as good as it should be.

I don't have a neuro either I just cant see the purpose. My PCP does everything I need and the same applies to MRI's if I had a stroke or something or if they THOUGHT that I had a stroke I would be first in line. But I had/have MS and it isn't going away it slowly gets worse and they are expensive and uncomfortable so what is the point?

Don't get me wrong it is all necessary when you are trying to find out why you are sick. But afterward if you are on a DMD and what to know if it is spreading or getting worse then by all means a neuro and MRI's are the ticket. But for me meh I am not interested.

[agate]

My decision-making is often quite impaired. It's not so much that I shillyshally around, unable to decide. It's more that I make decisions impulsively and regret them.

Also, in a situation calling for a split-second decision, I often fail miserably.

I seem to take too long to process information coming through the senses. If I'm watching a movie with fast action in it, I have to replay scenes repeatedly and still don't always understand what happened.

One big advantage to watching movies on DVDs at home is that you can do that.

I guess I don't have a neuro either. I had one while I was on Avonex or Copaxone but since going off the DMDs I saw no need to go back to the neuro. He saw no need for me to come back either. I believe 2016 was suggested.

[SuzE-Q]

I'm like that too, Joan when I'm watching tv or a movie. But I think it's more because I'm not concentrating and it doesn't have my full attention. I read somewhere a psychologist wrote that young minds are at risk because they are storing information less securely because today's generation does not give their full attention to one task anymore. When they're doing one thing, they tend to also be checking or writing emails, on more than one computer screen switching back and forth, thinking about something else, etc. We are not focusing our attention in as committed a manner on one thing at a time like we used to, and as a result, our memories are not as deeply formed as they need to be to maintain strong memories for retrieval or processing.

I know for me, when I work, I tend to be more scatter-brained and rather than fully complete a task, I keep coming up with new thoughts or new questions a few minutes later when I thought I'd finished. I think that's probably MS. I have word-find difficulty which is likely MS too, I'll say "that THING over there" rather than remember the item's actual name.

[Jeanie Z]

:) Hi everyone. I make decisions okay. Sometimes I wait until I'm sure I have chosen right but most of the things I have to decide today are not earth shaking.

I too have no neurologist. I have been on LDN (low dose naltrexone) for 15 years and my MS has stayed the same since I started LDN. My primary I see twice a year and he RX's the things I take. If I have a problem I can make an extra appointment. (Info on LDN at Only registered and activated users can see links., Click Here To Register...)

I've been playing Solitaire again today. Staying in until time to go to the MS dinner because it is cold for
WPB. We're going to 35-40 again tonight. Jeanie :)

[SalpalSally]

How long into your MS did it turn to SPMS, Sally? And would you rather have the more dramatic fluctuations of RRMS but at least with a little remission, or the slower, but unfortunately more progressive and permanent SPMS?

I rolled into SPMS at about age 63 or so, after or during, stopping all DMDs.
Started LDN about that time and have not progressed in Disability, but a
little, since. NO, I would not like to go back to RRMS. I hated it and suffered
a bunch through my younger, fun, productive years and don't wish to repeat
that. Although I was thrilled to be in remission, I feared when the bomb would
drop and it did, many times, in the last 20 some years.

If I were younger and had this situation, I would, most likely feel differently,
but I'm older and more content with it, I guess. Go figure??

[Mal L]

I find that decision-making and judgment go hand in hand. Also, one good area for them both
is planning trips and recreational activities.

[renee]

A lot depends on how I feel, physically and psych wise.
With too little sleep or coming off a druggy night, I can expect almost nothing of myself.
Under a deadline I become anxious, scattered and a tad OCD.

On those rare feel good, rested, ready to attack the world days
my decision making is well formulated and quick.
Downright shark-like.
If I'm making decisions based on spoken or written language that is ambiguous
or can be interpreted in different ways I call the language police.

I am very deliberate, somewhat slow, when trying to articulate all the components
leading to the decision. This bothers some folks, but wiser now,
I recognize my brain was always faster than my word formulation.

Some doc thought I might be RRMS but he wasn't sure.
Progression has been minimal.

[SuzE-Q]

Wow, Sally, that's quite the long run with RRMS!

Retrospection is always an interesting exercise, isn't it?

renee, yes, the feelings of being overwhelmed when put under pressure with a tight deadline- GGRRR!!! That happens to me too, I HATE that. You are definitely smart as a tack still, no question!

Mal, agreed!

[SalpalSally]

Wow, Sally, that's quite the long run with RRMS!

After my 1st exacerbation, I had MS light in the first 25 years.