Decision making in Parkinson's disease: Analysis of behavioral and physiological patterns in the Iowa gambling task

• Published in: Movement disorders 2008-03, Vol.23 (4), p.547-552
• Main Authors: Kobayakawa, Mutsutaka, Koyama, Shinichi, Mimura, Masaru, Kawamura, Mitsuru
• Format: Article
• Language: English
• Subjects: Aged; Amygdala - physiopathology; Biological and medical sciences; Cognition Disorders - diagnosis; Cognition Disorders - epidemiology; Cognition Disorders - physiopathology; Decision Making; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Female; Galvanic Skin Response; Gambling - psychology; Humans; Iowa gambling task; Male; Medical sciences; Memory Disorders - diagnosis; Memory Disorders - epidemiology; Memory Disorders - physiopathology; Neurology; Neuropsychological Tests; Parkinson Disease - diagnosis; Parkinson Disease - physiopathology; Parkinson Disease - psychology; Parkinson's disease; Prospective Studies; Psychological Tests; Psychomotor Disorders - diagnosis; Psychomotor Disorders - epidemiology; Psychomotor Disorders - physiopathology; Risk-Taking; Severity of Illness Index; skin conductance response; social cognition; Social Perception; Visual Perception - physiology
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.21865

Recent studies suggest that social recognition processes are affected by Parkinson's disease (PD). However, whether PD patients exhibit behavioral changes is still controversial. The purpose of the present study was to examine the decision making of PD patients performing the Iowa Gambling Task (IGT). We recruited a large number of early, nondemented PD patients for the IGT. We also recorded the skin conductance responses (SCRs) during the task as a measure of emotional arousal. Compared with the normal control (NC) subjects, PD patients selected more disadvantageous decks in the IGT, and their SCRs were lower than those of NC subjects before making decisions and after receiving reward or punishment. The tendency toward risky choices was not correlated with age, education, global cognitive function, or the severity of the disease. These results confirmed that the decision making of PD patients was affected by the disease, rather than by other cognitive functions; moreover, such behavior was related to lower emotional responses. Behavioral and SCR patterns of PD patients were similar to those of amygdala‐damaged patients. The response bias toward risky choices in PD may be explained by the dysfunction of the amygdala, which is known to be involved in risk evaluation. © 2007 Movement Disorder Society