title: Decision-making impairments in patients with Parkinson's disease.
abstract: A high percentage of Parkinson's disease (PD) patients show cognitive impairments in addition to the cardinal motor symptoms. These deficits primarily concern executive functions most probably linked to dysfunctions in prefrontal regions due to decreased dopaminergic transmission in fronto-striatal loops. To investigate possible associations between decision-making and executive functions in PD, we examined 20 non-demented PD patients and 20 healthy control subjects with a neuropsychological test battery and the Game of Dice Task. In this computerised decision-making task, the rules for gains and losses and the winning probabilities are obvious and stable. Thus, strategic components besides feedback processing might influence decision-making in this task. We found that PD patients were impaired in the Game of Dice task performance and that the frequency of disadvantageous choices correlated with both executive functions and feedback processing. We suggest that decision-making deficits of PD patients in explicit gambling situations might be associated with dysfunctions in two different fronto-striatal loops: the limbic-orbitofrontal-striatal loop, involved in feedback processing, and the dorsolateral prefrontal-striatal loop, involved in executive functions.
authors.affiliation: Department of Physiological Psychology, University of Bielefeld, Bielefeld, Germany. m.brand@uni-bielefeld.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Brand
authors.forename: Kirsten
authors.initials: K
authors.lastname: Labudda
authors.forename: Elke
authors.initials: E
authors.lastname: Kalbe
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Hilker
authors.forename: David
authors.initials: D
authors.lastname: Emmans
authors.forename: Gerd
authors.initials: G
authors.lastname: Fuchs
authors.forename: Josef
authors.initials: J
authors.lastname: Kessler
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Markowitsch
mesh_terms: D000368:Aged; D002755:Choice Behavior / Q000502:physiology; D003657:Decision Making / Q000502:physiology; D005246:Feedback / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D005715:Gambling / Q000523:psychology; D005717:Games, Experimental; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D017397:Prefrontal Cortex / Q000503:physiopathology; D011340:Problem Solving / Q000502:physiology; D013223:Statistics as Topic