Motivation, reward, and Parkinson's disease: influence of dopatherapy
Motivation, reward, and Parkinson's disease: influence of dopatherapy
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DOI：
10.1016/s0028-3932(02)00108-2
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发表时间：
2002-01-01
期刊：
影响因子：
2.6
通讯作者：
Dubois, B
中科院分区：
文献类型：
--
作者：
Czernecki, V;Pillon, B;Dubois, B
“眼窝额叶”和“扣带”纹状额叶环以及调节其功能的中边缘多巴胺能系统与动物的动机和对强化的敏感性有关。帕金森病（PD）提供了一个模型来评估它们对人类的影响。本研究的目的是调查非痴呆和抑郁PD患者对强化的动机和敏感性，并通过比较“开”（含左旋多巴）和“关”（不含左旋多巴）状态的患者来评估多巴胺能治疗的影响。23名PD患者在“开”和“关”状态下与28名对照进行比较，使用：(1)冷漠量表；(2)刺激-奖励学习、逆转和消退任务；（三）赌博任务。PD患者表现为：(1)轻度冷漠；(2)刺激-奖励学习和逆转功能受损，而消退功能不受损；(3)在第一次评估中能够完成赌博任务，但在第二次评估中不能。这些不同的缺陷之间没有显著的相关性。L-Dopa治疗明显改善了动机，但对其他变量的影响有限且对比明显，在逆转中减少了遗漏错误的数量，但在消失中增加了坚持错误的数量。这些研究结果表明：(1)纹状额回路与人类动机和外显和内隐强化敏感性有关；(2)左旋多巴对动机的主观评价有积极影响，但对奖励敏感性有相反的影响。(C) 2002 Elsevier Science Ltd.版权所有。
"Orbitofrontal" and "cingulate" striatofrontal loops and the mesolimbic dopaminergic system that modulates their function have been implicated in motivation and sensitivity to reinforcement in animals. Parkinson's disease (PD) provides a model to assess their implications in humans. The aims of the study were to investigate motivation and sensitivity to reinforcement in non-demented and -depressed PD patients and to evaluate the influence of dopaminergic therapy by comparing patients in "on" (with L-Dopa) and "off' (without L-Dopa) states. Twenty-three PD patients were compared, in both the "on" and "off' states, to 28 controls, using: (1) an Apathy Scale; (2) Stimulus-Reward Learning, Reversal, and Extinction tasks; and (3) a Gambling task. PD patients were found: (1) mildly apathetic; (2) impaired on Stimulus-Reward Learning and Reversal, but not on Extinction; and (3) able to progress in the Gambling task during the first, but not the second assessment. There was no significant correlation between these various deficits. L-Dopa treatment clearly improved motivation, but had more limited and contrasting effects on other variables, decreasing the number of omission errors in Reversal, but increasing the number of perseveration errors in Extinction. These results suggest: (1) an implication of striatofrontal loops in human motivation and explicit and implicit sensitivity to reinforcement; (2) a positive influence Of L-Dopa treatment on the subjective evaluation of motivation, but contrasting effects on reward sensitivity. (C) 2002 Elsevier Science Ltd. All rights reserved.