Decision-making under risk is improved by both dopaminergic medication and subthalamic stimulation in Parkinson's disease.
Inconsistent findings regarding the effects of dopaminergic medication (MED) and deep brain stimulation (DBS) of the subthalamic nucleus (STN) on decision making processes and impulsivity in Parkinson's disease (PD) patients have been reported. This study investigated the influence of MED and STN-DBS on decision-making under risk. Eighteen non-demented PD patients, treated with both MED and STN-DBS (64.3±10.2years, UPDRS III MED off, DBS off 45.5±17.1) were tested with the Game of Dice Task (GDT) which probes decision-making under risk during four conditions: MED on/DBS on, MED on/DBS off, MED off/DBS on, and MED off/DBS off. Task performance across conditions was compared analyzing two GDT-parameters: (i) the "net score" indicating advantageous decisions, and (ii) the patient's ability to use negative feedback. Significantly higher GDT net scores were observed in Med on in contrast to Med off conditions as well as in DBS on versus DBS off conditions. However, no effect of therapy for the patient's ability to make use of negative feedback could be detected. The data suggest a positive influence of both MED and STN-DBS on making decisions under risk in PD patients, an effect which seems to be mediated by mechanisms other than the use of negative feedback.
Department of Neurology, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany. Electronic address: janaboller@aol.com.
Jana K
JK
Boller
Department of Neurology, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany; Institute of Neurosciences and Medicine (INM-3), Cognitive Neurology Section, Research Centre Jülich, Wilhelm-Johnen-Strasse, 52428 Jülich, Germany. Electronic address: michael.barbe@uk-koeln.de.
Michael T
MT
Barbe
Department of Neurology, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany. Electronic address: amande.pauls@uk-koeln.de.
K Amande M
KA
Pauls
Department of Neurology, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany. Electronic address: christiane.reck@uk-koeln.de.
Christiane
C
Reck
General Psychology: Cognition, Faculty of Engineering, University of Duisburg-Essen, Campus Duisburg, Forsthausweg 2, 47048 Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Ahrendahls Wiese 199, 45141 Essen, Germany. Electronic address: matthias.brand@uni-due.de.
Matthias
M
Brand
Department of Neurology, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany. Electronic address: franziska.maier@uk-koeln.de.
Franziska
F
Maier
Department of Neurology, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany; Institute of Neurosciences and Medicine (INM-3), Cognitive Neurology Section, Research Centre Jülich, Wilhelm-Johnen-Strasse, 52428 Jülich, Germany. Electronic address: gereon.fink@uk-koeln.de.
Gereon R
GR
Fink
Department of Neurology, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany. Electronic address: lars.timmermann@uk-koeln.de.
Lars
L
Timmermann
Department of Neurology, University of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany; Institute of Gerontology & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Vechta, Driverstrasse 22, 49377 Vechta, Germany. Electronic address: elke.kalbe@uk-koeln.de.
Elke
E
Kalbe
D000368:Aged; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D003657:Decision Making / Q000187:drug effects* / Q000502:physiology; D046690:Deep Brain Stimulation / Q000379:methods*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D030141:Feedback, Psychological; D005260:Female; D005717:Games, Experimental; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy*; D012306:Risk; D012309:Risk-Taking; D020531:Subthalamic Nucleus / Q000502:physiology
D018491:Dopamine Agonists
Cognition; Decision-making; Deep brain stimulation; Dopaminergic medication; Parkinson's disease