Study Finds MS Patients Experience a Social Disconnect

MS patients were significantly outscored by a control group in a series of social interaction tests.

People with multiple sclerosis (MS) may have a harder time reading others’ emotions and catching social cues, new research suggests.

Scientists in Portugal have published a study showing MS patients had much lower scores than a control group on tests designed to study one’s ability to read social cues. The research may lead to a better understanding of how MS affects the lives of patients, according to Sonia Batista (pictured), MD, the study’s corresponding author.

“Understanding how MS affects the ‘social brain’ has not been well studied, but the ability to interpret other people’s feelings and intentions may influence people’s ability to maintain a job and their relationships with family and friends,” Batista, a neurologist and faculty member at the University of Coimbra, Portugal, said. “These skills are very important for people with MS since having good support is one of the main factors in whether people have a good quality of life.”

Batista and colleagues wanted to know how microstructural changes to normal-appearing white matter (NAWM) affect the social interactions of MS patients. To find out, the team enrolled 60 MS patients and 60 healthy control patients in a series of tests related to social interaction. Of the MS patients, 50 had relapsing-remitting MS; the remaining 10 had secondary progressive MS.

Much of the study was based on “Theory of Mind” skills, which measure a person’s ability to identify and interpret other people’s emotions, desires, and beliefs.

The 120 study participants were shown photographs of people’s eyes, along with four words describing mental states. They were asked to pick the word that best described the mental state of the person in the photo.

Patients with MS had an average score of 59% on the test. The control group scored an average of 82%.

Similarly, participants were shown a series of silent videos of people interacting. For each video, participants saw two words and picked the one that best described the interaction.

In the video test, MS patients averaged scores of 75%, compared to 88% for the control group.

Within the MS group, patients with higher T1 and T2 lesion counts tended to have lower scores than other patients. Other factors, such as length of time a patient had had the disease and the patient’s level of disability, did not appear to have an impact on social interaction scores.

When the patients were given MRI scans, the people who had extensive abnormalities in their white matter had the lowest scores on the social tests. The most extensive damage was seen in the uncinate fasciculus, fornix and corpus callosum, areas that are key to social interactions.

"It appears that there is a disconnect in the social brain network," Batista said, in a press release.

That insight could also help physicians better sort through changes in MS patients’ behavior. For instance, when an MS patient withdraws socially, it can be difficult for a doctor to discern whether that withdrawal is due to new MS-related limitations, or due to a psychiatric condition like depression. The MRI analysis in the new study might offer a simpler way for physicians to confirm or quantify role of MS in the behavior change.

Batista noted that the tests were only performed once, and thus it’s not possible to know the extent to which social interactions deteriorate over time for MS patients. She said it’s also unclear how much these social cue deficits are related to other cognitive troubles in MS patients, such as loss of memory.

The study, titled “Disconnection as a mechanism for social cognition impairment in multiple sclerosis,” was published May 31 in Neurology.

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