Decision-making in Parkinson's disease patients with and without pathological gambling

Background and purpose: Pathological gambling (PG) in Parkinson’s disease (PD) is a frequent impulse control disorder associated mainly with dopamine replacement therapy. As impairments in decision‐making were described independently in PG and PD, the objective of this study was to assess decision‐...

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Bibliographic Details
Published in:	European journal of neurology Vol. 17; no. 1; pp. 97 - 102
Main Authors:	Rossi, M., Gerschcovich, E. R., De Achaval, D., Perez-Lloret, S., Cerquetti, D., Cammarota, A., Inés Nouzeilles, M., Fahrer, R., Merello, M., Leiguarda, R.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-01-2010 John Wiley & Sons, Inc
Subjects:	Aged Amygdala - drug effects Amygdala - physiopathology Basal Ganglia - drug effects Basal Ganglia - physiopathology Cognition Disorders - chemically induced Cognition Disorders - diagnosis Cognition Disorders - psychology Decision making Decision Making - drug effects Decision Making - physiology Disability Evaluation Disruptive, Impulse Control, and Conduct Disorders - chemically induced Disruptive, Impulse Control, and Conduct Disorders - diagnosis Disruptive, Impulse Control, and Conduct Disorders - psychology Dopamine Dopamine - metabolism Dopamine Agents - adverse effects Female Gambling Gambling - psychology Humans impulse control disorders Iowa gambling task Male Middle Aged movement disorders Neuropsychological Tests Parkinson Disease - drug therapy Parkinson's disease pathological gambling Prefrontal Cortex - drug effects Prefrontal Cortex - physiopathology social behavior Social Behavior Disorders - chemically induced Social Behavior Disorders - diagnosis Social Behavior Disorders - psychology Task Performance and Analysis ventromedial prefrontal cortex
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Summary:	Background and purpose: Pathological gambling (PG) in Parkinson’s disease (PD) is a frequent impulse control disorder associated mainly with dopamine replacement therapy. As impairments in decision‐making were described independently in PG and PD, the objective of this study was to assess decision‐making processes in PD patients with and without PG. Methods: Seven PD patients with PG and 13 age, sex, education and disease severity matched PD patients without gambling behavior were enrolled in the study. All patients were assessed with a comprehensive neuropsychiatric and cognitive evaluation, including tasks used to assess decision‐making abilities under ambiguous or risky situations, like the Iowa Gambling Task (IGT), the Game of Dice Task and the Investment Task. Results: Compared to PD patients without gambling behavior, those with PG obtained poorer scores in the IGT and in a rating scale of social behavior, but not in other decision‐making and cognitive tasks. Conclusions: Low performance in decision‐making under ambiguity and abnormal social behavior distinguished PD patients with PG from those without this disorder. Dopamine replacement therapy may induce dysfunction of the ventromedial prefrontal cortex and amygdala‐ventral striatum system, thus increasing the risk for developing PG.
Bibliography:	istex:1EEC4C574FCD2B102E46CDF5B94A73B661C40CB6 ArticleID:ENE2792 ark:/67375/WNG-ZDKD9HXQ-W ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1351-5101 1468-1331
DOI:	10.1111/j.1468-1331.2009.02792.x