Researchers found that multiple sclerosis (MS) patients have impaired decision-making abilities, especially as the disease progresses into the late stages, according to a new study from the University of Alberta’s Faculty of Medicine & Dentistry and published in BMC Neurology.

The study’s lead author Ashley Radomski developed the game of dice task (GDT), a test designed to determine MS patients’ abilities to assess risk. GDT was a part of a two-hour standardized neuropsychological test to evaluate participant’s working and verbal memory, visual-spatial abilities and motor function. It challenged participants to weigh the risks of throwing dice by selecting a combination of 1, 2, 3, or 4 digits as a predicted outcome of each roll. Participants could make a less risky choice by choosing more numbers in a combination but this also meant lower rewards for a correct guess.

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The results showed that patients with later stages of MS, indicated by the subtype of MS or by greater structural changes in the brain, had more considerable decision-making disabilities than those who had less severe MS.

Radomski noted MS patients or their family members may find it beneficial to keep a journal to track decision-making patterns over time. This journal should be shared with the patient’s primary physician or neurologist for full assessment. Esther Fujiwara, an associate professor in the Department of Psychiatry, hopes to further this research by testing whether stress plays a bigger role in decision-making for patients with MS vs. those without MS.

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