Altered delay discounting in neurodegeneration: insight into the underlying mechanisms and perspectives for clinical applications
Altered delay discounting in neurodegeneration: insight into the underlying mechanisms and perspectives for clinical applications
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DOI：
10.1016/j.neubiorev.2023.105048
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发表时间：
2023-01-27
影响因子：
8.2
通讯作者：
Migliaccio，Raffaella
中科院分区：
文献类型：
--
作者：
Godefroy，Valerie;Sezer，Idil;Migliaccio，Raffaella
更陡峭的延迟折扣（即，未来的奖励被认为不如眼前的奖励有价值的程度）被提议作为不同健康状况，特别是精神障碍的一种转诊断过程。冲动性决策是不同神经退行性疾病的标志，但在神经退行性疾病领域对延迟折扣知之甚少。我们回顾了帕金森病（PD）和痴呆（阿尔茨海默病/ AD或额颞叶痴呆/ FTD）患者的延迟折扣研究。我们提出延迟折扣可能是神经退行性过程的早期标志。我们提出了这样的想法：延迟折扣的改变与神经退行性疾病中重叠但不同的神经认知机制有关：PD中多巴胺能相关的奖励处理障碍、AD中内侧颞叶萎缩导致的记忆/投射缺陷、FTD中眶额萎缩导致的奖励处理改变。神经退行性变可以提供一个框架来解释基于价值的决策的神经心理机制。此外，延迟折扣可能成为临床实践中感兴趣的标记，特别是用于鉴别诊断。
Steeper delay discounting (i.e., the extent to which future rewards are perceived as less valuable than immediate ones) has been proposed as a transdiagnostic process across different health conditions, in particular psychiatric disorders. Impulsive decision-making is a hallmark of different neurodegenerative conditions but little is known about delay discounting in the domain of neurodegenerative conditions. We reviewed studies on delay discounting in patients with Parkinson’s disease (PD) and in patients with dementia (Alzheimer’s disease / AD or frontotemporal dementia / FTD). We proposed that delay discounting could be an early marker of the neurodegenerative process. We developed the idea that altered delay discounting is associated with overlapping but distinct neurocognitive mechanisms across neurodegenerative diseases: dopaminergic-related disorders of reward processing in PD, memory/projection deficits due to medial temporal atrophy in AD, modified reward processing due to orbitofrontal atrophy in FTD. Neurodegeneration could provide a framework to decipher the neuropsychological mechanisms of value-based decision-making. Further, delay discounting could become a marker of interest in clinical practice, in particular for differential diagnosis.