Pavlovian bias in Parkinson's disease: an objective marker of impulsivity that modulates with deep brain stimulation
Pavlovian bias in Parkinson's disease: an objective marker of impulsivity that modulates with deep brain stimulation
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DOI：
10.1038/s41598-020-69760-y
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发表时间：
2020-08-10
影响因子：
4.6
通讯作者：
Gunduz, Aysegul
中科院分区：
文献类型：
--
作者：
Eisinger, Robert S.;Scott, Bonnie M.;Gunduz, Aysegul
冲动是帕金森病(PD)的常见症状。适应行为受到优先行动--奖励和不行动--避免损失的巴甫洛夫偏见的影响。我们的目的是评估帕金森病患者冲动与巴甫洛夫偏见相关的假说，并评估多巴胺能药物和脑深部刺激(DBS)是否影响巴甫洛夫偏见。PD DBS队列(N=37)完成了基于奖励的Go/No Go任务，并计算了偏差测量。该DBS队列在三种情况下完成任务：ON-MED/PRE-DBS、OFF-MED/OFF-DBS和ON-MED/ON-DBS。参与者还完成了对冲动的自我报告测量。多巴胺能药物与较低的动作奖赏偏向相关，而DBS与较高的动作奖赏偏向相关。冲动与较高的行动-奖励偏向有关，而不是与不作为-避免损失的偏向有关。我们还在一个独立的、非DBS PD队列中复制了这种关联(N=88)。总体而言，我们建立了冲动的客观行为标记物，并表明DBS通过放大自动反应来影响冲动。我们的结果表明，在驾驶冲动行为中，奖励而不是惩罚回避的重要性。这项工作提供了对冲动的病理生理基础的洞察，特别是药物和DBS相关的冲动在帕金森病中的作用。
Impulsivity is a common symptom in Parkinson's disease (PD). Adaptive behavior is influenced by prepotent action-reward and inaction-avoid loss Pavlovian biases. We aimed to assess the hypothesis that impulsivity in PD is associated with Pavlovian bias, and to assess whether dopaminergic medications and deep brain stimulation (DBS) influence Pavlovian bias. A PD DBS cohort (N=37) completed a reward-based Go/No-Go task and bias measures were calculated. This DBS cohort completed the task under three conditions: on-med/pre-DBS, off-med/off-DBS, and on-med/on-DBS. Participants also completed self-reported measures of impulsivity. Dopaminergic medication was associated with lower action-reward bias while DBS was associated with higher action-reward bias. Impulsivity was associated with higher action-reward bias but not inaction-avoid loss bias. We furthermore replicated this association in an independent, non-DBS PD cohort (N=88). Overall we establish an objective behavioral marker of impulsivity and show that DBS affects impulsivity by amplifying automated responding. Our results point to the importance of reward rather than punishment avoidance in driving impulsive behaviors. This work provides insight into the pathophysiological underpinnings of impulsivity and especially medication and DBS-associated impulsivity in PD.