title: Iowa gambling task in Parkinson's disease.
abstract: Cognitive impairments are common in patients with Parkinson's disease (PD) from the early stages. Recent studies reported that medicated PD patients have poor performances, with respect to age-matched healthy controls, in a decision-making task like the Iowa Gambling Task (IGT), which detects the ability to alter choice behavior in response to fluctuations in reward contingencies. The IGT principally activates functions related to the orbitofrontal cortex, which plays a crucial role in the generation of outcome expectancies and processing of rewards. The analysis of IGT performances of PD patients is of particular interest because PD represents a good clinical model to study reward processing when its neural bases are affected by a neuropathology or are overdosed by dopaminergic therapies. As a matter of fact, either PD-related neuropathology in advanced stages of the disease or the dopamine replacement therapy from earlier stages of PD may affect the functioning of the orbitofrontal cortex. Three causal hypotheses on a dysfunctional decision making in PD patients, as assessed by IGT, are discussed. Finally, the possible relation between the phenomenon of decision-making impairment and impulse control disorders, a psychiatric complication observed with increasing frequency in PD patients, is discussed.
authors.affiliation: Neurology Unit, Unita Sanitaria Locale of Viareggio, Viareggio, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Poletti
authors.forename: Paolo
authors.initials: P
authors.lastname: Cavedini
authors.forename: Ubaldo
authors.initials: U
authors.lastname: Bonuccelli
mesh_terms: D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D003657:Decision Making / Q000502:physiology*; D015259:Dopamine Agents / Q000627:therapeutic use; D056344:Executive Function / Q000502:physiology; D005625:Frontal Lobe / Q000473:pathology; D005715:Gambling / Q000523:psychology*; D006801:Humans; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy / Q000473:pathology / Q000523:psychology; D012189:Retrospective Studies
chemical_list: D015259:Dopamine Agents