title: In a rush to decide: deep brain stimulation and dopamine agonist therapy in Parkinson's disease.
abstract: BACKGROUND
  It has been suggested that all patients with Parkinson's disease (PD) who undergo functional neurosurgery have difficulties in slowing down in high conflict tasks. However, it is unclear whether concomitant dopaminergic medication is responsible for this impairment.
  
  
  OBJECTIVE
  To assess perceptual decision making in PD patients with bilateral deep brain stimulation.
  
  
  METHODS
  We tested 27 PD patients with bilateral deep brain stimulation on a task in which participants had to filter task relevant information from background noise. Thirteen patients were treated with Levodopa monotherapy and 14 patients were treated with Levodopa in combination with a dopamine agonist. RESULTS were compared to healthy matched controls.
  
  
  RESULTS
  We found that all PD patients who were treated with a dopamine agonist made faster decisions than controls and PD patients who were not exposed to a dopamine agonist. Further, all patients made more errors than controls, but there was no difference between the two patient groups.
  
  
  CONCLUSIONS
  Our results suggest that dopamine agonist therapy rather than deep brain stimulation is likely responsible for the inability to slow down in high conflict situations in PD. These results further strengthen the need to reduce dopamine agonists in PD patients undergoing functional neurosurgery in order to prevent them making inadvisable decisions.
authors: Department of Molecular Neuroscience and Reta Lila Weston Institute for Neurological Studies, University of London, London, UK Department of Neurology, University Clinic Innsbruck, Tyrol, Austria.
authors: Atbin
authors: A
authors: Djamshidian
authors: Cork University Hospital, University College Cork, Cork, Ireland.
authors: Sean S
authors: SS
authors: O'Sullivan
authors: Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, London, UK.
authors: Alessandro
authors: A
authors: Tomassini
authors: Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, London, UK.
authors: Thomas
authors: T
authors: Foltynie
authors: Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, London, UK.
authors: Patricia
authors: P
authors: Limousin
authors: Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, UCL, London, UK.
authors: Iciar
authors: I
authors: Aviles-Olmos
authors: Department of Molecular Neuroscience and Reta Lila Weston Institute for Neurological Studies, University of London, London, UK.
authors: Thomas T
authors: TT
authors: Warner
authors: Department of Molecular Neuroscience and Reta Lila Weston Institute for Neurological Studies, University of London, London, UK.
authors: Andrew J
authors: AJ
authors: Lees
authors: Laboratory of Neuropsychology, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
authors: Bruno B
authors: BB
authors: Averbeck
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D046690:Deep Brain Stimulation / Q000379:methods*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D010300:Parkinson Disease / Q000628:therapy*; D011930:Reaction Time / Q000187:drug effects / Q000502:physiology; D012720:Severity of Illness Index; D020531:Subthalamic Nucleus / Q000502:physiology*; D016896:Treatment Outcome
chemical_list: D018491:Dopamine Agonists; D007980:Levodopa
keywords: Deep brain stimulation; Parkinson's disease; dopamine agonists; perceptual decision making