{"id":507,"date":"2015-05-04T04:02:35","date_gmt":"2015-05-04T04:02:35","guid":{"rendered":"https:\/\/blogs.bmj.com\/jnnp\/?p=507"},"modified":"2015-05-04T04:02:35","modified_gmt":"2015-05-04T04:02:35","slug":"decision-making-and-multiple-sclerosis-there-is-hope","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/jnnp\/2015\/05\/04\/decision-making-and-multiple-sclerosis-there-is-hope\/","title":{"rendered":"Decision-making and multiple sclerosis: there is hope!"},"content":{"rendered":"<p>One of the most common concerns that I hear as a clinician from MS patients concerns their ability to organise and look after their lives. MS patients who have even the most mild degrees of physical disability report an alarmingly significant effect of the illness of their ability to multi-task and to just get things done in the course of a day. Due to the rapid rate of progress in developing new drugs for MS, we don\u2019t see the levels of physical disability that we used to compared to patients who developed the condition in decades past. Yet, regardless of which medication an MS patient is taking, almost all report fatigue and some difficulty with decision making. The difficulty as a clinician is diagnosing this as there are no simple bedside tests to assess you go about making the sorts of daily decisions that one needs to as a functioning adult. Treatments? Don\u2019t go there, there is simply nothing out there for this problem.<\/p>\n<p>For any disease, you can\u2019t really develop treatments that work without a very detailed knowledge of the mechanism that cause that disease. That\u2019s my lead-in for telling MS patients that there is little I can offer them for any type of cognitive change that they may experience. Fortunately, Muhlert and colleagues <a href=\"http:\/\/jnnp.bmj.com\/content\/86\/5\/530.abstract\">http:\/\/jnnp.bmj.com\/content\/86\/5\/530.abstract<\/a> have provided an interesting paper in the current issue of JNNP which provides the first evidence that changes in decision-making in MS patients are related to changes in specific parts of the brain\u2019s grey and white matter. These are the studies that we need to make headway into a very prevalent issue for MS patients and their families.<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>One of the most common concerns that I hear as a clinician from MS patients concerns their ability to organise and look after their lives. MS patients who have even the most mild degrees of physical disability report an alarmingly significant effect of the illness of their ability to multi-task and to just get things [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/jnnp\/2015\/05\/04\/decision-making-and-multiple-sclerosis-there-is-hope\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":161,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-507","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Decision-making and multiple sclerosis: there is hope! - JNNP blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/jnnp\/2015\/05\/04\/decision-making-and-multiple-sclerosis-there-is-hope\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Decision-making and multiple sclerosis: there is hope! - JNNP blog\" \/>\n<meta property=\"og:description\" content=\"One of the most common concerns that I hear as a clinician from MS patients concerns their ability to organise and look after their lives. MS patients who have even the most mild degrees of physical disability report an alarmingly significant effect of the illness of their ability to multi-task and to just get things [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/jnnp\/2015\/05\/04\/decision-making-and-multiple-sclerosis-there-is-hope\/\" \/>\n<meta property=\"og:site_name\" content=\"JNNP blog\" \/>\n<meta property=\"article:published_time\" content=\"2015-05-04T04:02:35+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/2015\\\/05\\\/04\\\/decision-making-and-multiple-sclerosis-there-is-hope\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/2015\\\/05\\\/04\\\/decision-making-and-multiple-sclerosis-there-is-hope\\\/\"},\"author\":{\"name\":\"\",\"@id\":\"\"},\"headline\":\"Decision-making and multiple sclerosis: there is hope!\",\"datePublished\":\"2015-05-04T04:02:35+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/2015\\\/05\\\/04\\\/decision-making-and-multiple-sclerosis-there-is-hope\\\/\"},\"wordCount\":291,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/#organization\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/2015\\\/05\\\/04\\\/decision-making-and-multiple-sclerosis-there-is-hope\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/2015\\\/05\\\/04\\\/decision-making-and-multiple-sclerosis-there-is-hope\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/2015\\\/05\\\/04\\\/decision-making-and-multiple-sclerosis-there-is-hope\\\/\",\"name\":\"Decision-making and multiple sclerosis: there is hope! - JNNP blog\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/#website\"},\"datePublished\":\"2015-05-04T04:02:35+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/2015\\\/05\\\/04\\\/decision-making-and-multiple-sclerosis-there-is-hope\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/2015\\\/05\\\/04\\\/decision-making-and-multiple-sclerosis-there-is-hope\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/2015\\\/05\\\/04\\\/decision-making-and-multiple-sclerosis-there-is-hope\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Decision-making and multiple sclerosis: there is hope!\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/jnnp\\\/\",\"name\":\"JNNP blog\",\"description\":\"The official JNNP blog. 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