Decision-making impairments in patients with Parkinson's disease.
Decision-making impairments in patients with Parkinson's disease.
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DOI：
10.1155/2004/578354
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发表时间：
2004
影响因子：
2.8
通讯作者：
Markowitsch HJ
中科院分区：
文献类型：
--
作者：
Brand M;Labudda K;Kalbe E;Hilker R;Emmans D;Fuchs G;Kessler J;Markowitsch HJ
除了主要的运动症状外，很高比例的帕金森病（PD）患者还表现出认知障碍。这些缺陷主要涉及执行功能，最有可能与前额叶区功能障碍有关，这是由于额叶-纹状体环路中多巴胺能传递减少所致。为了探讨决策和执行功能之间可能存在的关联，我们研究了20名非痴呆PD患者和20名健康对照组与神经心理测试电池和骰子游戏任务。在这个计算机化的决策任务中，得失和获胜概率的规则是明显和稳定的。因此，除了反馈处理的战略组件可能会影响决策在这个任务。我们发现，PD患者受损的骰子游戏任务的性能和不利的选择与执行功能和反馈处理的频率。我们认为，决策缺陷的PD患者在明确的赌博情况下可能与功能障碍，在两个不同的额-纹状体回路：边缘眶额-纹状体回路，参与反馈处理，和背外侧前额叶-纹状体回路，参与执行功能。
A high percentage of Parkinson’s disease (PD) patients show cognitive impairments in addition to the cardinal motor symptoms. These deficits primarily concern executive functions most probably linked to dysfunctions in prefrontal regions due to decreased dopaminergic transmission in fronto-striatal loops. To investigate possible associations between decision-making and executive functions in PD, we examined 20 non-demented PD patients and 20 healthy control subjects with a neuropsychological test battery and the Game of Dice Task. In this computerised decision-making task, the rules for gains and losses and the winning probabilities are obvious and stable. Thus, strategic components besides feedback processing might influence decision-making in this task. We found that PD patients were impaired in the Game of Dice task performance and that the frequency of disadvantageous choices correlated with both executive functions and feedback processing. We suggest that decision-making deficits of PD patients in explicit gambling situations might be associated with dysfunctions in two different fronto-striatal loops: the limbic-orbitofrontal-striatal loop, involved in feedback processing, and the dorsolateral prefrontal-striatal loop, involved in executive functions.