Data_Set_Cognitive Impairment and the Shift Toward Deontological reasoning in MSx

<b>Abstract (200/200)</b><b>Background</b>: Multiple sclerosis (MS) is associated with frequent cognitive impairments and altered social cognition, including a greater tendency for deontological moral judgments compared to healthy controls. The mechanisms underlying these differences, particularly the role of cognitive domains, remain unclear.<b>Methods</b>: 45 with MS (pwMS) and 45 matched controls completed a comprehensive neuropsychological and affective battery, including the BDI-FS, STAI, TAS-20, and tests of processing speed, memory, executive function, and working memory. Moral judgment was assessed using 20 French-validated moral dilemma vignettes, measuring utilitarian/deontological choices, permissiveness, emotional reactivity, and relativity. Group differences were examined with Mann-Whitney <i>U</i> tests and mixed-effects logistic regression. Correlations between cognitive/affective measures and moral outcomes were computed within each group.<b>Results</b>: Both groups were less likely to endorse utilitarian choices in personal versus impersonal dilemmas. MS was associated with fewer utilitarian responses overall, independent of dilemma type. In PwMS, working memory and executive function predicted greater moral permissiveness and fewer deontological choices. In controls, processing speed and memory were associated with permissiveness, but not with utilitarian/deontological balance.<b>Discussion</b>: Findings suggest that cognitive impairment in pwMS selectively constrains utilitarian moral reasoning, while in controls, cognitive resources primarily support flexible, permissive judgments rather than shifting fundamental moral reasoning style.