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The effects of reward and punishment contingencies on decision-making in multiple sclerosis

Published online by Cambridge University Press:  27 June 2006

HELGA NAGY
Affiliation:
Department of Neurology, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Szeged, Hungary
KRISZTINA BENCSIK
Affiliation:
Department of Neurology, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Szeged, Hungary
CECÍLIA RAJDA
Affiliation:
Department of Neurology, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Szeged, Hungary
KRISZTINA BENEDEK
Affiliation:
Department of Neurology, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Szeged, Hungary
SÁNDOR BENICZKY
Affiliation:
Department of Neurology, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Szeged, Hungary
SZABOLCS KÉRI
Affiliation:
Department of Psychiatry, Faculty of Medicine, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Szeged, Hungary
LÁSZLÓ VÉCSEI
Affiliation:
Department of Neurology, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Szeged, Hungary Neurology Research Group of the Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary

Abstract

Many patients with multiple sclerosis (MS) show cognitive and emotional disorders. The purpose of this study is to evaluate the role of contingency learning in decision-making in young, non-depressed, highly functioning patients with MS (n = 21) and in matched healthy controls (n = 30). Executive functions, attention, short-term memory, speed of information processing, and selection and retrieval of linguistic material were also investigated. Contingency learning based on the cumulative effect of reward and punishment was assessed using the Iowa Gambling Test (IGT). In the classic ABCD version of the IGT, advantageous decks are characterized by immediate small reward but even smaller future punishment. In the modified EFGH version, advantageous decks are characterized by immediate large punishment but even larger future reward. Results revealed that patients with MS showed significant dysfunctions in both versions of the IGT. Performances on neuropsychological tests sensitive to dorsolateral prefrontal functions did not predict and did not correlate with the IGT scores. These results suggest that patients with MS show impaired performances on tasks designed to assess decision-making in a situation requiring the evaluation of long-term outcomes regardless of gain or loss, and that this deficit is not a pure consequence of executive dysfunctions (JINS, 2006, 12, 559–565.)

Type
Research Article
Copyright
© 2006 The International Neuropsychological Society

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