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[Assessment of decision-making capacity in primary and secondary progressive multiple sclerosis].

INTRODUCTION
Patients with multiple sclerosis (MS) may have an impairment in their decision-making. Altered decision making is a known cause of functional impairment in daily living activities and in the patient's autonomy, negatively contributing to their quality of life.


OBJECTIVE
The current study assessed the decision-making capacity of patients with primary progressive multiple sclerosis (PPMS) and secondary progressive multiple sclerosis (SPMS) compared to healthy control subjects.


PATIENTS AND METHODS
Nineteen patients with multiple sclerosis (9 PPMS and 10 SPMS) and 18 healthy controls participated in the study. Decision-making was evaluated using a computerized version of the Iowa Gambling Task (IGT), a test created to simulate punishment-reward contingencies in a real-life manner.


RESULTS
Overall, the PPMS group performed more poorly than the control and SPMS groups on the IGT. The SPMS group was not significantly impaired compared to control group on the task, but showed abnormalities of IGT performance similar to the PPMS group.


CONCLUSIONS
The authors suggest that the existence of decision- making impairments in patients with multiple sclerosis can be explained by a difficulty in the acquisition of stimulus-reward contingencies.