Decision making in Parkinson's disease: Analysis of behavioral and physiological patterns in the Iowa gambling task

Abstract

Recent studies suggest that social recognition processes are affected by Parkinson's disease (PD). However, whether PD patients exhibit behavioral changes is still controversial. The purpose of the present study was to examine the decision making of PD patients performing the Iowa Gambling Task (IGT). We recruited a large number of early, nondemented PD patients for the IGT. We also recorded the skin conductance responses (SCRs) during the task as a measure of emotional arousal. Compared with the normal control (NC) subjects, PD patients selected more disadvantageous decks in the IGT, and their SCRs were lower than those of NC subjects before making decisions and after receiving reward or punishment. The tendency toward risky choices was not correlated with age, education, global cognitive function, or the severity of the disease. These results confirmed that the decision making of PD patients was affected by the disease, rather than by other cognitive functions; moreover, such behavior was related to lower emotional responses. Behavioral and SCR patterns of PD patients were similar to those of amygdala-damaged patients. The response bias toward risky choices in PD may be explained by the dysfunction of the amygdala, which is known to be involved in risk evaluation.

Impulsivity and Parkinson's disease: More than just disinhibition

“…Neuroimaging studies on healthy subjects (HS) showed that the activated regions during IGT were those underlying both somatic activation and future oriented decisionmaking [7]. However, recent reports showed the complexity of this task that might also be considered as a measure of risk taking [1,[8][9][10][11]. In particular, poor performance during the first part of the task has been related to ambiguous risk taking [12][13][14][15].…”

The Role of Feedback in Decision Making

“…maximize one's profits. Some have shown that PDs' overall winnings are substantially less than HCs, as indicated by failure to select the advantageous deck (Czerneki et al, 2002;Kobayakawa et al, 2008;Mimura et al, 2006). But, others have shown that the overall success in maximizing earnings is equivalent in both HCs and PDs (Euteneuer et al, 2010;Poletti, et al, 2010;Thiel et al, 2003).…”

Neuropsychological and Radiological Assessments of Two Cases with Apparent Idiopathic Rapid Eye Movement Sleep Behaviour Disorder

“…The SCR patterns were compared with those of 12 age-matched normal controls. The procedures are described in detail in an earlier study [13]. …”

“…Although decision-making [12,13] and facial expression recognition [14,15,16] are social cognitive skills that are known to be impaired in PD, no studies have been conducted to date on decision-making in RBD. Furthermore, our case study focused on whether these cognitive symptoms, autonomic dysfunction, and abnormal dopamine metabolism appear in a particular order.…”