title: Functional anatomy of outcome evaluation during Iowa Gambling Task performance in patients with Parkinson's disease: an fMRI study.
abstract: The aim of this study was to investigate the functional anatomy of decision-making during the Iowa Gambling Task in patients with Parkinson's disease. We used event-related functional magnetic resonance imaging (fMRI) during a computerized version of IGT to compare 18 PD patients on dopaminergic medication in the ON state and 18 healthy control subjects. Our analyses focused on outcome evaluation following card selection, because we expected this aspect of decision-making to be impaired in PD patients. The PD patients exhibited lower activation of the left putamen than the control group as a reaction to penalty. Using psychophysiological interaction analysis, we identified decreased functional connectivity between the right globus pallidus internus and the left anterior cingulate gyrus in the PD group. In contrast, increased connectivity between these structures was observed after penalty in the control group. Our results suggest altered functioning of the basal ganglia and their connections with the cortical structures involved in the limbic loop (e.g., the limbic fronto-striatal circuit of the basal ganglia) during decision-making in PD patients. Differences in the response to loss could be associated with insufficient negative reinforcement after a loss in PD patients in the ON state in comparison to a healthy population.
authors.affiliation: CEITEC-Central European Institute of Technology, Behavioral and Social Neuroscience Research Group, Masaryk University, University Campus Bohunice, Building A4, Brno, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Gescheidt
authors.forename: Radek
authors.initials: R
authors.lastname: Mareček
authors.forename: Michal
authors.initials: M
authors.lastname: Mikl
authors.forename: Kristína
authors.initials: K
authors.lastname: Czekóová
authors.forename: Tomáš
authors.initials: T
authors.lastname: Urbánek
authors.forename: Jiří
authors.initials: J
authors.lastname: Vaníček
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Shaw
authors.forename: Martin
authors.initials: M
authors.lastname: Bareš
mesh_terms: D001931:Brain Mapping; D003657:Decision Making / Q000502:physiology*; D005260:Female; D005917:Globus Pallidus / Q000503:physiopathology*; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000503:physiopathology*; D011699:Putamen / Q000503:physiopathology*