title: Impaired learning of punishments in Parkinson's disease with and without impulse control disorder.
abstract: To document specific learning mechanisms in patients with Parkinson's disease (PD) with and without impulse control disorder (ICD). Thirty-two PD patients receiving dopamine replacement therapy (DRT) were investigated. Sixteen were diagnosed with ICD (ICD+) and 16 PD patients matched for levodopa equivalence dosage, and DRT duration and severity of disease did not show impulsive behavior (non-ICD). Short-term learning of inhibitory control was assessed by an experimental procedure which was intended to mimic everyday life. Correct inhibition especially, had to be learned without reward (passive avoidance), and the failure to inhibit a response was punished (punishment learning). Results were compared to 16 healthy controls (HC) matched for age and sex. In ICD+patients within-session learning of non-rewarded inhibition was at chance levels. Whereas healthy controls rapidly developed behavioral inhibition, non-ICD patients were also significantly impaired compared to HC, but gradually developed some degree of control. Both patient groups showed significantly decreased learning if the failure to withhold a response was punished. PD patients receiving DRT show impaired ability to acquire both punishment learning and passive avoidance learning, irrespective of whether or not ICD was developed. In ICD+PD patients, behavioral inhibition is nearly absent. Results demonstrate that by means of subtle learning paradigms it is possible to identify PD-DRT patients who show subtle alterations of punishment learning. This may be a behavioral measure for the identification of PD patients who are prone to develop ICD if DRT is continued.
authors.affiliation: Department of Psychology, Martin-Luther-University Halle-Wittenberg, Emil-Abderhalden-Str. 26-27, 06099, Halle (Saale), Germany. bernd.leplow@psych.uni-halle.de.
authors.forename: Bernd
authors.initials: B
authors.lastname: Leplow
authors.affiliation: Department of Psychology, Martin-Luther-University Halle-Wittenberg, Emil-Abderhalden-Str. 26-27, 06099, Halle (Saale), Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Sepke
authors.affiliation: Department of Psychology, Martin-Luther-University Halle-Wittenberg, Emil-Abderhalden-Str. 26-27, 06099, Halle (Saale), Germany.
authors.forename: Robby
authors.initials: R
authors.lastname: Schönfeld
authors.affiliation: Department of Psychology, Martin-Luther-University Halle-Wittenberg, Emil-Abderhalden-Str. 26-27, 06099, Halle (Saale), Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Pohl
authors.affiliation: Neurological Specialist Hospital for Movement Disorders/Parkinson, Paracelsusring 6a, 14547, Beelitz-Heilstätten, Germany.
authors.forename: Henriette
authors.initials: H
authors.lastname: Oelsner
authors.affiliation: Department of Psychology, Martin-Luther-University Halle-Wittenberg, Emil-Abderhalden-Str. 26-27, 06099, Halle (Saale), Germany.
authors.forename: Lea
authors.initials: L
authors.lastname: Latzko
authors.affiliation: Neurological Specialist Hospital for Movement Disorders/Parkinson, Paracelsusring 6a, 14547, Beelitz-Heilstätten, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Ebersbach
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001362:Avoidance Learning; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000150:complications*; D015259:Dopamine Agents / Q000627:therapeutic use; D056344:Executive Function; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy / Q000523:psychology*; D011678:Punishment
chemical_list: D000978:Antiparkinson Agents; D015259:Dopamine Agents
keywords: Behavioral addiction; Dopamine replacement therapy; Impulse control disorder; Learning; Parkinson’s disease