Emotional experience in patients with clinically isolated syndrome and early multiple sclerosis

Abstract

Background Evidence suggests changes in the processing of emotional information (EP) in people with multiple sclerosis (MS). It is unclear which functional domains of EP are affected, whether these changes are secondary to other MS‐related neuropsychological or psychiatric symptoms and if EP changes are present in early MS. Objective To investigate EP in patients with early MS (clinically isolated syndrome and early relapsing/remitting MS) and healthy controls (HC). Methods 29 patients without neuropsychological deficits and 29 matched HC were presented IAPS‐pictures with negative, positive or neutral content. Participants rated the induced emotion regarding valence and arousal using 9‐level Likert scales. A speeded recognition test assessed memory for the emotional stimuli and for the emotional modulation of response time. A subgroup of participants was tested during a magnetic resonance imaging (MRI) session. Results Patients in the MRI‐subgroup rated the experience induced by pictures with positive or negative emotional content significantly weaker than HCs. Further, these patients were significantly less aroused watching the IAPS pictures. There were neither effects in the non‐MRI‐subgroup nor effects on emotional memory or response times. Conclusion EP changes may be present in early MS in the form of flattened emotional experience on both the valence and arousal dimension. These changes do not appear to be secondary to neuropsychological or neuropsychiatric deficits. The fact that emotional flattening was only found in the MRI‐setting, suggests that EP changes may be unmasked within stressful environments and points to the potential yet underestimated impact of the MRI‐setting on behavioral outcomes.