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Chen XJ, Kwak Y. Contribution of the sensorimotor beta oscillations and the cortico-basal ganglia-thalamic circuitry during value-based decision making: A simultaneous EEG-fMRI investigation. Neuroimage 2022; 257:119300. [PMID: 35568351 DOI: 10.1016/j.neuroimage.2022.119300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 04/20/2022] [Accepted: 05/09/2022] [Indexed: 10/18/2022] Open
Abstract
In decision neuroscience, the motor system has primarily been considered to be involved in executing choice actions. However, a competing perspective suggests its engagement in the evaluation of options, traditionally considered to be performed by the brain's valuation system. Here, we investigate the role of the motor system in value-based decision making by determining the neural circuitries associated with the sensorimotor beta oscillations previously identified to encode decision options. In a simultaneous EEG-fMRI study, participants evaluated reward and risk associated with a forthcoming action. A significant sensorimotor beta desynchronization was identified prior to and independent of response. The level of beta desynchronization showed evidence of encoding the reward levels. This beta desynchronization covaried, on a trial-by-trial level, with BOLD activity in the cortico-basal ganglia-thalamic circuitry. In contrast, there was only a weak covariation within the valuation network, despite significant modulation of its BOLD activity by reward levels. These results suggest that the way in which decision variables are processed differs in the valuation network and in the cortico-basal ganglia-thalamic circuitry. We propose that sensorimotor beta oscillations indicate incentive motivational drive towards a choice action computed from the decision variables even prior to making a response, and it arises from the cortico-basal ganglia-thalamic circuitry.
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Affiliation(s)
- Xing-Jie Chen
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA 01003, USA
| | - Youngbin Kwak
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA 01003, USA.
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2
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Benke T, Marksteiner J, Ruepp B, Weiss EM, Zamarian L. Decision Making under Risk in Patients Suffering from Schizophrenia or Depression. Brain Sci 2021; 11:brainsci11091178. [PMID: 34573199 PMCID: PMC8470442 DOI: 10.3390/brainsci11091178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/31/2021] [Accepted: 09/05/2021] [Indexed: 11/16/2022] Open
Abstract
Studies have reported difficulties in decision making for patients with schizophrenia or depression. Here, we investigated whether there are differences between schizophrenia patients, depressed patients, and healthy individuals (HC) when decisions are to be made under risk and cognitive flexibility is required. We were also interested in the relationships between decision making, cognitive functioning, and disease severity. Thirty HC, 28 schizophrenia patients, and 28 depressed patients underwent structured clinical assessments and were assessed by the Positive and Negative Syndrome Scale or Hamilton Rating Scale. They performed the Probability-Associated Gambling (PAG) Task and a neuropsychological test battery. Both patient groups obtained lower scores than HC in memory and executive function measures. In the PAG task, relative to HC, depressed patients made slower decisions but showed a comparable number of advantageous decisions or strategy flexibility. Schizophrenia patients were slower, riskier, and less flexible compared to HC. For them, the decision making behavior correlated with the symptom severity. In both groups, decision making scores correlated with memory and executive function scores. Patients with schizophrenia or depression may have difficulties under risk when quick and flexible decisions are required. These difficulties may be more pronounced in patients who have marked cognitive deficits or severe clinical symptoms.
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Affiliation(s)
- Theresa Benke
- Department of Psychiatry and Psychotherapy A, Hall State Hospital, 6060 Hall in Tirol, Austria; (T.B.); (J.M.); (B.R.)
| | - Josef Marksteiner
- Department of Psychiatry and Psychotherapy A, Hall State Hospital, 6060 Hall in Tirol, Austria; (T.B.); (J.M.); (B.R.)
| | - Beatrix Ruepp
- Department of Psychiatry and Psychotherapy A, Hall State Hospital, 6060 Hall in Tirol, Austria; (T.B.); (J.M.); (B.R.)
| | - Elisabeth M. Weiss
- Department of Psychology, University of Innsbruck, 6020 Innsbruck, Austria;
| | - Laura Zamarian
- Department of Neurology, Medical University of Innsbruck, 6020 Innsbruck, Austria
- Correspondence:
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Perach R, Rusted J, Harris PR, Miles E. Emotion regulation and decision-making in persons with dementia: A scoping review. DEMENTIA 2021; 20:1832-1854. [PMID: 33226266 PMCID: PMC8216314 DOI: 10.1177/1471301220971630] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Emotion is integral to decision-making, and emotion regulation is associated with improved well-being in older age. Persons with dementia are likely to experience impairments in emotion regulation processes that can potentially contribute to differential decision-making and well-being outcomes. To promote the development of theoretical models of well-being in dementia, we review the quantitative evidence concerning the associations between emotion regulation and decision-making in dementia. METHODS Scoping review. RESULTS Seven studies of persons with dementia met our criteria. In persons with frontotemporal lobar degeneration, emotion regulation processes that precede the emotional experience were associated with decision-making in a moral (but not uncertainty) context. Independent of type of dementia, evidence concerning the associations between emotion regulation processes that occur after emotion is experienced and decision-making was mixed and drew on different methodologies. No studies relating to the associations between decision-making in dementia and several emotion regulation processes and strategies were found. CONCLUSIONS In this review, we sought to clarify the concept of everyday decision-making in dementia and map the current state of evidence concerning its associations with emotion regulation. Our findings show that emotion regulation processes are associated with decision-making in dementia, depending on type of decision-making assessment and emotional experience. We outline the gaps in the literature to set a research agenda for promoting our understanding of how emotion regulation processes can shape the various decisions that are made by persons with dementia on a daily basis.
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Affiliation(s)
- Rotem Perach
- School of Psychology, University of Sussex, Brighton, UK
| | | | | | - Eleanor Miles
- School of Psychology, University of Sussex, Brighton, UK
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Salvatore MF, Soto I, Alphonso H, Cunningham R, James R, Nejtek VA. Is there a Neurobiological Rationale for the Utility of the Iowa Gambling Task in Parkinson's Disease? JOURNAL OF PARKINSONS DISEASE 2021; 11:405-419. [PMID: 33361612 PMCID: PMC8150623 DOI: 10.3233/jpd-202449] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Up to 23% of newly diagnosed, non-demented, Parkinson’s disease (PD) patients experience deficits in executive functioning (EF). In fact, EF deficits may occur up to 39-months prior to the onset of motor decline. Optimal EF requires working memory, attention, cognitive flexibility, and response inhibition underlying appropriate decision-making. The capacity for making strategic decisions requires inhibiting imprudent decisions and are associated with noradrenergic and dopaminergic signaling in prefrontal and orbitofrontal cortex. Catecholaminergic dysfunction and the loss of noradrenergic and dopaminergic cell bodies early in PD progression in the aforementioned cortical areas likely contribute to EF deficits resulting in non-strategic decision-making. Thus, detecting these deficits early in the disease process could help identify a significant portion of individuals with PD pathology (14–60%) before frank motor impairment. A task to evaluate EF in the domain of non-strategic decision-making might be useful to indicate the moderate loss of catecholamines that occurs early in PD pathology prior to motor decline and cognitive impairment. In this review, we focus on the potential utility of the Iowa Gambling Task (IGT) for this purpose, given significant overlap between in loss of dopaminergic and noradrenergic cells bodies in early PD and the deficits in catecholamine function associated with decreased EF. As such, given the loss of catecholamines already well-underway after PD diagnosis, we evaluate the potential utility of the IGT to identify the risk of therapeutic non-compliance and a potential companion approach to detect PD in premotor stages.
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Affiliation(s)
- Michael F Salvatore
- Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Isabel Soto
- Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Helene Alphonso
- John Peter Smith Health Network, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Rebecca Cunningham
- College of Pharmacy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Rachael James
- Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Vicki A Nejtek
- Institute for Healthy Aging, University of North Texas Health Science Center, Fort Worth, TX, USA
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5
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Kjær SW, Callesen MB, Larsen L, Borghammer P, Østergaard K, Damholdt MF. Applied strategy in the Iowa Gambling Task: Comparison of individuals with Parkinson's disease to healthy controls. J Clin Exp Neuropsychol 2020; 42:425-435. [PMID: 32283989 DOI: 10.1080/13803395.2020.1749237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Decision-making impairments in Parkinson's disease (PD) have frequently been measured using the Iowa Gambling Task (IGT), though results have been inconsistent. At present, task performance has primarily been evaluated based on the total IGT score, and there is a need for further analysis of the strategy of older individuals with PD and healthy control (HC) participants in IGT. OBJECTIVE The present study aims to explore possible impairments in IGT performance in individuals with PD compared to healthy controls using strategy analysis, extending previous results on this subject, and to discuss potential effects of medication on task performance. METHODS 67 individuals with PD and 29 HC participants completed the IGT. Results were analyzed to evaluate impairments, applied strategies, presence of subgroups, and potential effects of medication on performance. RESULTS Both groups obtained a low overall IGT score and individuals with PD had significantly lower total IGT scores compared to HC participants. Regression analysis showed a small, but significant relationship between levodopa and dopamine agonist dosage and total IGT score, indicating that medication level could be a marker of level of executive functions. Subgroups of advantageous and disadvantageous choosers differed significantly in deck preferences for both groups. CONCLUSION Individuals with PD were significantly impaired in IGT performance, both in overall scores and in detailed analyses, and they utilized an inefficient strategy during task performance. However, HC participants also presented with a suboptimal strategy and results suggest the presence of subgroups in both individuals with PD and HC participants, which may reflect age-related changes. These results are in line with previous research on performance of older individuals and alternative deck preferences in the IGT and underline the importance of considering the applied strategy in the evaluation of IGT performance.
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Affiliation(s)
- Sophie Wohlert Kjær
- Department of Psychology and Behavioural Sciences, Aarhus University , Aarhus, Denmark
| | - Mette Buhl Callesen
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University , Aarhus, Denmark
| | - Lars Larsen
- Department of Psychology and Behavioural Sciences, Aarhus University , Aarhus, Denmark
| | - Per Borghammer
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital , Aarhus, Denmark
| | - Karen Østergaard
- Department of Neurology, Aarhus University Hospital , Aarhus, Denmark
| | - Malene Flensborg Damholdt
- Department of Psychology and Behavioural Sciences, Aarhus University , Aarhus, Denmark.,Department of Philosophy and the History of Ideas, Aarhus University , Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University , Aarhus, Denmark
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6
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D'Aurizio G, Migliore S, Curcio G, Squitieri F. Safer Attitude to Risky Decision-Making in Premanifest Huntington's Disease Subjects. Front Psychol 2019; 10:846. [PMID: 31057466 PMCID: PMC6477566 DOI: 10.3389/fpsyg.2019.00846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 03/29/2019] [Indexed: 01/18/2023] Open
Abstract
Huntington’s disease (HD) is an inherited neurodegenerative disorder characterized by involuntary, jerky movements, incoordination, behavioral changes and subtle executive and cognitive impairment starting before motor symptoms. Our study aimed to assess the risky decision-making process in premanifest (pre) HD subjects, by means Game of Dice Task (GDT). As dependent variables, several GDT outcomes have been taken into consideration. We recruited 30 subjects (15 females) with preHD (i.e., Diagnosis Confidence Level < 4; Total Motor Score < 10), and 21 age, gender and education matched neurologically normal subjects (11 females). GDT is a computer-guided task where subjects are invited to watch the digits on which to bet and to evaluate the related potential risk to win or loss. Our results showed that decision and feedback times were longer in preHD than in neurologically normal group in both disadvantageous and advantageous choices. PreHD subjects provided a greater number of “safe” strategies, taken with longer decision-making time than neurologically normal subjects, showing a reduced propensity to risk. Such behavior, characterized by increased slowness in acting and providing answers, might contribute to delineate a behavioral and cognitive profile in preHD.
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Affiliation(s)
- Giulia D'Aurizio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Simone Migliore
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Giuseppe Curcio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ferdinando Squitieri
- Huntington and Rare Diseases Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
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Burgio F, Delazer M, Meneghello F, Pertl MT, Semenza C, Zamarian L. Cognitive Training Improves Ratio Processing and Decision Making in Patients with Mild Cognitive Impairment. J Alzheimers Dis 2018; 64:1213-1226. [DOI: 10.3233/jad-180461] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | | | - Carlo Semenza
- San Camillo Hospital IRCCS, Venice, Italy
- Department of Neuroscience (Padova Neuroscience Center), University of Padua, Italy
| | - Laura Zamarian
- Department of Neurology, Medical University of Innsbruck, Austria
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8
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Pertl MT, Benke T, Zamarian L, Delazer M. Effects of Healthy Aging and Mild Cognitive Impairment on a Real-Life Decision-Making Task. J Alzheimers Dis 2018; 58:1077-1087. [PMID: 28527216 DOI: 10.3233/jad-170119] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this study, we investigated the effects of age and of mild cognitive impairment (MCI) on decision making under risk by adopting a task representing real-life health-related situations and involving complex numerical information. Moreover, we assessed the relationship of real-life decision making to other cognitive functions such as number processing, executive functions, language, memory, and attention. For this reason, we compared the performance of 19 healthy, relatively younger adults with that of 18 healthy older adults and the performance of the 18 healthy older adults with that of 17 patients with MCI. Results indicated difficulties in real-life decision making for the healthy older adults compared with the healthy, relatively younger adults. Difficulties of patients with MCI relative to the healthy older adults arose in particular in difficult items requiring processing of frequencies and fractions. Significant effects of age and of MCI in processing frequencies were also evident in a ratio number comparison task. Decision-making performance of healthy participants and of the patient group correlated significantly with number processing. There was a further significant correlation with executive functions for the healthy participants and with reading comprehension for the patients. Our results suggest that healthy older individuals and patients with MCI make less advantageous decisions when the information is complex and high demands are put on executive functions and numerical abilities. Moreover, we show that executive functions and numerical abilities are not only essential in laboratory gambling tasks but also in more realistic and ecological decision situations within the health context.
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Affiliation(s)
- Marie-Theres Pertl
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.,Department of Psychology, Leopold Franzens University, Innsbruck, Austria
| | - Thomas Benke
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Laura Zamarian
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Margarete Delazer
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
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9
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Moran RJ, Kishida KT, Lohrenz T, Saez I, Laxton AW, Witcher MR, Tatter SB, Ellis TL, Phillips PEM, Dayan P, Montague PR. The Protective Action Encoding of Serotonin Transients in the Human Brain. Neuropsychopharmacology 2018; 43:1425-1435. [PMID: 29297512 PMCID: PMC5916372 DOI: 10.1038/npp.2017.304] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/01/2017] [Accepted: 11/28/2017] [Indexed: 01/14/2023]
Abstract
The role of serotonin in human brain function remains elusive due, at least in part, to our inability to measure rapidly the local concentration of this neurotransmitter. We used fast-scan cyclic voltammetry to infer serotonergic signaling from the striatum of 14 brains of human patients with Parkinson's disease. Here we report these novel measurements and show that they correlate with outcomes and decisions in a sequential investment game. We find that serotonergic concentrations transiently increase as a whole following negative reward prediction errors, while reversing when counterfactual losses predominate. This provides initial evidence that the serotonergic system acts as an opponent to dopamine signaling, as anticipated by theoretical models. Serotonin transients on one trial were also associated with actions on the next trial in a manner that correlated with decreased exposure to poor outcomes. Thus, the fluctuations observed for serotonin appear to correlate with the inhibition of over-reactions and promote persistence of ongoing strategies in the face of short-term environmental changes. Together these findings elucidate a role for serotonin in the striatum, suggesting it encodes a protective action strategy that mitigates risk and modulates choice selection particularly following negative environmental events.
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Affiliation(s)
- Rosalyn J Moran
- Department of Engineering Mathematics, School of Computer Science, Electrical and Electronic Engineering, and Engineering Mathematics, University of Bristol, Bristol, UK
| | - Kenneth T Kishida
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, USA,Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Terry Lohrenz
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA, USA
| | - Ignacio Saez
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Adrian W Laxton
- Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mark R Witcher
- Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Stephen B Tatter
- Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Thomas L Ellis
- Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Paul EM Phillips
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA,Department of Pharmacology, University of Washington, Seattle, WA, USA
| | - Peter Dayan
- The Gatsby Computational Neuroscience Unit, University College London, London, UK
| | - P Read Montague
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA, USA,Department of Physics, Virginia Tech, Blacksburg, VA, USA,Wellcome Trust Centre for Neuroimaging, University College London, London, UK,Virginia Tech Carilion, Research Institute, 2 Riverside Circle, Roanoke, VA 24016, USA, Tel: +1 540 526 2006, Fax: +1 540 982 3805, E-mail:
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10
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Unterberger I, Zamarian L, Prieschl M, Bergmann M, Walser G, Luef G, Javor A, Ransmayr G, Delazer M. Risky Decision Making in Juvenile Myoclonic Epilepsy. Front Neurol 2018; 9:195. [PMID: 29632513 PMCID: PMC5879545 DOI: 10.3389/fneur.2018.00195] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 03/13/2018] [Indexed: 11/13/2022] Open
Abstract
It is not known whether patients with juvenile myoclonic epilepsy (JME) differ from healthy people in decision making under risk, i.e., when the decision-making context offers explicit information about options, probabilities, and consequences already from the beginning. In this study, we adopted the Game of Dice Task-Double to investigate decision making under risk in a group of 36 patients with JME (mean age 25.25/SD 5.29 years) and a group of 38 healthy controls (mean age 26.03/SD 4.84 years). Participants also underwent a comprehensive neuropsychological assessment focused on frontal executive functions. Significant group differences were found in tests of psychomotor speed and divided attention, with the patients scoring lower than the controls. Importantly, patients made risky decisions more frequently than controls. In the patient group, poor decision making was associated with poor executive control, poor response inhibition, and a short interval since the last seizure episode. Executive control and response inhibition could predict 42% of variance in the frequency of risky decisions. This study indicates that patients with JME with poorer executive functions are more likely to make risky decisions than healthy controls. Decision making under risk is of major importance in every-day life, especially with regard to treatment decisions and adherence to long-term medical therapy. Since even a single disadvantageous decision may have long-lasting consequences, this finding is of high relevance.
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Affiliation(s)
- Iris Unterberger
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Laura Zamarian
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Manuela Prieschl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Melanie Bergmann
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gerald Walser
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gerhard Luef
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrija Javor
- Department of Neurology 2, Kepler University Hospital, Linz, Austria
| | - Gerhard Ransmayr
- Department of Neurology 2, Kepler University Hospital, Linz, Austria
| | - Margarete Delazer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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11
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Pasion R, Gonçalves AR, Fernandes C, Ferreira-Santos F, Barbosa F, Marques-Teixeira J. Meta-Analytic Evidence for a Reversal Learning Effect on the Iowa Gambling Task in Older Adults. Front Psychol 2017; 8:1785. [PMID: 29075222 PMCID: PMC5641897 DOI: 10.3389/fpsyg.2017.01785] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 09/26/2017] [Indexed: 01/08/2023] Open
Abstract
Iowa Gambling Task (IGT) is one of the most widely used tools to assess economic decision-making. However, the research tradition on aging and the Iowa Gambling Task (IGT) has been mainly focused on the overall performance of older adults in relation to younger or clinical groups, remaining unclear whether older adults are capable of learning along the task. We conducted a meta-analysis to examine older adults' decision-making on the IGT, to test the effects of aging on reversal learning (45 studies) and to provide normative data on total and block net scores (55 studies). From the accumulated empirical evidence, we found an average total net score of 7.55 (±25.9). We also observed a significant reversal learning effect along the blocks of the IGT, indicating that older adults inhibit the prepotent response toward immediately attractive options associated with high losses, in favor of initially less attractive options associated with long-run profit. During block 1, decisions of older adults led to a negative gambling net score, reflecting the expected initial pattern of risk-taking. However, the shift toward more safe options occurred between block 2 (small-to-medium effect size) and blocks 3, 4, 5 (medium-to-large effect size). These main findings highlight that older adults are able to move from the initial uncertainty, when the possible outcomes are unknown, to decisions based on risk, when the outcomes are learned and may be used to guide future adaptive decision-making.
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Affiliation(s)
- Rita Pasion
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal.,Católica Porto Business School, Universidade Católica Portuguesa, Porto, Portugal
| | - Ana R Gonçalves
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - Carina Fernandes
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - Fernando Ferreira-Santos
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - João Marques-Teixeira
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
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12
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Evens R, Hoefler M, Biber K, Lueken U. The Iowa Gambling Task in Parkinson's disease: A meta-analysis on effects of disease and medication. Neuropsychologia 2016; 91:163-172. [DOI: 10.1016/j.neuropsychologia.2016.07.032] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 07/14/2016] [Accepted: 07/27/2016] [Indexed: 11/27/2022]
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13
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Rzezak P, Lima EM, Pereira F, Gargaro AC, Coimbra E, de Vincentiis S, Velasco TR, Leite JP, Busatto GF, Valente KD. Decision-making in patients with temporal lobe epilepsy: Delay gratification ability is not impaired in patients with hippocampal sclerosis. Epilepsy Behav 2016; 60:158-164. [PMID: 27206236 DOI: 10.1016/j.yebeh.2016.04.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 04/18/2016] [Accepted: 04/19/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Decision-making abilities have rarely been examined in patients with temporal lobe epilepsy related to hippocampal sclerosis (TLE-HS). We aimed to investigate the ability to delay gratification, a decision-making subdomain, in patients with intractable TLE-HS and to verify the association of delay gratification performance and cool executive function tests. METHODS We evaluated 27 patients with TLE-HS (mean age: 35.46 [±13.31] years; 7 males) and their cognitive performance was compared with that of 27 age- and gender-matched healthy controls (mean age: 35.33 [±12.05] years; 7 males), without epilepsy and psychiatric disorders. Patients were assessed using the delay discounting task (DDT) and tests of attention, shifting, inhibitory control, and concept formation. Results were correlated with clinical epilepsy variables such as age of onset, epilepsy duration, AED use, history of status epilepticus, febrile seizures, and the presence of generalized seizures. Statistical analysis was performed using one-way ANCOVA with years of education as a confounding factor. RESULTS Patients and controls demonstrated similar performance on DDT, showing similar discount rate (p=0.935) and probability rate (p=0.585). Delay gratification was not related to cool executive function tests (Digit Span, Stroop Color Test, Trail Making Test, Wisconsin Card Sorting Test, and Connors' CPT). History of status epilepticus, presence of generalized seizures and higher seizure frequency, age at onset, and epilepsy duration had a significant impact on DDT. CONCLUSION Patients with intractable TLE-HS showed unimpaired delay gratification abilities, being able to accept a higher delay and a lower amount of chance for receiving a higher reward in the future. Clinical variables related to the epilepsy severity impacted the performance on delay gratification. Impairment on cool aspects of executive function was unrelated to this decision-making domain.
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Affiliation(s)
- Patricia Rzezak
- Laboratory of Neuroimaging in Psychiatry (LIM 21),University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil; Group for the Study of Cognitive and Psychiatric Disorders in Epilepsy - Clinics Hospital,University of Sao Paulo (USP),Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA),University of Sao Paulo (USP),Brazil.
| | - Ellen Marise Lima
- Group for the Study of Cognitive and Psychiatric Disorders in Epilepsy - Clinics Hospital,University of Sao Paulo (USP),Brazil
| | - Fabricio Pereira
- Laboratory of Neuroimaging in Psychiatry (LIM 21),University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil
| | - Ana Carolina Gargaro
- Ribeirao Preto School of Medicine,Department of Neurosciences and Behavior,University of Sao Paulo (USP),Brazil
| | - Erica Coimbra
- Ribeirao Preto School of Medicine,Department of Neurosciences and Behavior,University of Sao Paulo (USP),Brazil
| | - Silvia de Vincentiis
- Laboratory of Clinical Neurophysiology,Psychiatry Department,University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil; Laboratory of Neuroimaging in Psychiatry (LIM 21),University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil; Group for the Study of Cognitive and Psychiatric Disorders in Epilepsy - Clinics Hospital,University of Sao Paulo (USP),Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA),University of Sao Paulo (USP),Brazil
| | - Tonicarlo Rodrigues Velasco
- Ribeirao Preto School of Medicine,Department of Neurosciences and Behavior,University of Sao Paulo (USP),Brazil
| | - João Pereira Leite
- Ribeirao Preto School of Medicine,Department of Neurosciences and Behavior,University of Sao Paulo (USP),Brazil
| | - Geraldo F Busatto
- Laboratory of Neuroimaging in Psychiatry (LIM 21),University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil; Group for the Study of Cognitive and Psychiatric Disorders in Epilepsy - Clinics Hospital,University of Sao Paulo (USP),Brazil
| | - Kette D Valente
- Laboratory of Clinical Neurophysiology,Psychiatry Department,University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil; Laboratory of Neuroimaging in Psychiatry (LIM 21),University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil; Group for the Study of Cognitive and Psychiatric Disorders in Epilepsy - Clinics Hospital,University of Sao Paulo (USP),Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA),University of Sao Paulo (USP),Brazil
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14
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Stevenson M, McDowell ME, Taylor BJ. Concepts for communication about risk in dementia care: A review of the literature. DEMENTIA 2016; 17:359-390. [PMID: 27178999 DOI: 10.1177/1471301216647542] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Communication about risk is central to decisions in dementia care. This review synthesises research on risk concepts and communication in dementia. Twelve bibliographic databases and one online search engine were searched up to February 2016. Reference lists of two related literature reviews were used. Thirty-four articles were identified that focused on risk concepts; two articles related to risk communication. Concepts were often socially constructed, and perceptions may differ from actual adverse outcomes. Perceptions of risk and thresholds of risk-tolerance varied between individuals with dementia, carers and professionals. Individuals with dementia were found to behave differently from controls when making decisions involving risk information in experimental settings. Cognitive impairment was also associated with lower health numeracy. These findings highlight the importance of communication between stakeholders when making decisions and of presenting information in an appropriate way to support informed and positive risk taking. Research is required on risk communication in dementia.
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Affiliation(s)
- Mabel Stevenson
- School of Sociology & Applied Social Studies, Ulster University, Northern Ireland
| | | | - Brian J Taylor
- School of Sociology & Applied Social Studies, Ulster University, Northern Ireland
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15
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Pineau F, Roze E, Lacomblez L, Bonnet AM, Vidailhet M, Czernecki V, Corvol JC. Executive functioning and risk-taking behavior in Parkinson's disease patients with impulse control disorders. J Neural Transm (Vienna) 2016; 123:573-81. [PMID: 27085342 DOI: 10.1007/s00702-016-1549-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 04/04/2016] [Indexed: 12/19/2022]
Abstract
Impulse control disorders (ICD) are common in Parkinson's disease (PD) and are associated with dopaminergic medication. The purpose of this study was to investigate executive function and risk-taking behavior in PD patients with ICD. 17 PD patients with ICD (ICD-PD) were compared to 20 PD patients without ICD (CTRL-PD) using neuropsychological and experimental tasks. Executive functions were assessed using standard executive testing (Conner's Performance Test, Modified Wisconsin Card Sorting Test, Trail Making Test and phonological verbal fluency). Subjects were also submitted to an experimental gambling task consisted of three decks of money cards: neutral deck (equal opportunity for gains as losses), winning deck (small amount of money with a positive balance) and loser deck (high amount of money with a negative balance), evaluating risk-taking behavior (number of cards picked in each deck) and valuation of the reward (subjective appreciation of the value of each deck). There was no significant difference in executive functioning between groups. Both groups selected more cards in the losing deck (high amount of money) as compared to the neutral deck (Mann-Whitney test, ICD-PD, p = 0.02; CTRL-PD, p = 0.003) and to the winning deck (Mann-Whitney test, ICD-PD p = 0.0001; CTRL-PD p = 0.003), suggesting an increased risk-taking behavior. Interestingly, we found that ICD-PD patients estimated the value of decks differently from CTRL-PD patients, taking into account mainly the positive reinforced value of the decks (Mann-Whitney test, p = 0.04). This study showed that executive pattern and risk-taking behavior are similar between ICD-PD and CTRL-PD patients. However, ICD-PD patients showed a specific deficit of the subjective estimation of the reward. Links between this deficit and metacognitive skills are discussed.
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Affiliation(s)
- Fanny Pineau
- Département des Maladies du Système Nerveux, Sorbonne Universités, UPMC Univ Paris 06, and INSERM UMRS_1127 and CIC_1422, and CNRS UMR_7225, and AP-HP, and ICM, Hôpital Pitié-Salpêtrière, 75013, Paris, France.
- Service de Neurologie, Hôpitaux Civils de Colmar, Bâtiment 59, 39 Avenue de la Liberté, 68000, Colmar, France.
| | - Emmanuel Roze
- Département des Maladies du Système Nerveux, Sorbonne Universités, UPMC Univ Paris 06, and INSERM UMRS_1127 and CIC_1422, and CNRS UMR_7225, and AP-HP, and ICM, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Lucette Lacomblez
- Département des Maladies du Système Nerveux, Sorbonne Universités, UPMC Univ Paris 06, and INSERM UMRS_1146 and CIC_1422, and AP-HP, and ICM, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Anne-Marie Bonnet
- Département des Maladies du Système Nerveux, Sorbonne Universités, UPMC Univ Paris 06, and INSERM UMRS_1127 and CIC_1422, and CNRS UMR_7225, and AP-HP, and ICM, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Marie Vidailhet
- Département des Maladies du Système Nerveux, Sorbonne Universités, UPMC Univ Paris 06, and INSERM UMRS_1127 and CIC_1422, and CNRS UMR_7225, and AP-HP, and ICM, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Virginie Czernecki
- Département des Maladies du Système Nerveux, Sorbonne Universités, UPMC Univ Paris 06, INSERM UMRS_975, and AP-HP, and ICM, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Jean-Christophe Corvol
- Département des Maladies du Système Nerveux, Sorbonne Universités, UPMC Univ Paris 06, and INSERM UMRS_1127 and CIC_1422, and CNRS UMR_7225, and AP-HP, and ICM, Hôpital Pitié-Salpêtrière, 75013, Paris, France
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16
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Diederich NJ, Goldman JG, Stebbins GT, Goetz CG. Failing as doorman and disc jockey at the same time: Amygdalar dysfunction in Parkinson's disease. Mov Disord 2015; 31:11-22. [PMID: 26650182 DOI: 10.1002/mds.26460] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 09/20/2015] [Accepted: 09/23/2015] [Indexed: 02/01/2023] Open
Abstract
In Braak's model of ascending degeneration in Parkinson's disease (PD), involvement of the amygdala occurs simultaneously with substantia nigra degeneration. However, the clinical manifestations of amygdalar involvement in PD have not been fully delineated. Considered a multitask manager, the amygdala is a densely connected "hub," coordinating and integrating tasks ranging from prompt, multisensorial emotion recognition to adequate emotional responses and emotional tuning of memories. Although phylogenetically predisposed to handle fear, the amygdala handles both aversive and positive emotional inputs. In PD, neuropathological and in vivo studies suggest primarily amygdalar hypofunction. However, as dopamine acts as an inverted U-shaped amygdalar modulator, medication-induced hyperactivity of the amygdala can occur. We propose that amygdalar (network) dysfunction contributes to reduced recognition of negative emotional face expressions, impaired theory of mind, reactive hypomimia, and impaired decision making. Similarly, impulse control disorders in predisposed individuals, hallucinations, anxiety, and panic attacks may be related to amygdalar dysfunction. When available, we discuss amygdala-independent trigger mechanisms of these symptoms. Although dopaminergic agents have mostly an activation effect on amygdalar function, adaptive and compensatory network changes may occur as well, but these have not been sufficiently explored. In conclusion, our model of amygdalar involvement brings together several elements of Parkinson's disease phenomenology heretofore left unexplained and provides a framework for testable hypotheses in patients during life and in autopsy analyses.
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Affiliation(s)
- Nico J Diederich
- Department of Neurosciences, Centre Hospitalier de Luxembourg, Luxembourg-City, Luxembourg.,Centre for Systems Biomedicine, University of Luxembourg, Campus Esch-Belval, Esch-s.-Alzette, Luxembourg.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Jennifer G Goldman
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Glenn T Stebbins
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Christopher G Goetz
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
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17
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Pertl MT, Benke T, Zamarian L, Delazer M. Decision Making and Ratio Processing in Patients with Mild Cognitive Impairment. J Alzheimers Dis 2015; 48:765-79. [PMID: 26402094 DOI: 10.3233/jad-150291] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Marie-Theres Pertl
- Department of Neurology, Medical University of Innsbruck, Austria
- Department of Psychology, Leopold Franzens University, Innsbruck, Austria
| | - Thomas Benke
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Laura Zamarian
- Department of Neurology, Medical University of Innsbruck, Austria
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18
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Self-reported strategies in decisions under risk: role of feedback, reasoning abilities, executive functions, short-term-memory, and working memory. Cogn Process 2015; 16:401-16. [DOI: 10.1007/s10339-015-0665-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 07/09/2015] [Indexed: 11/25/2022]
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19
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Ethical safety of deep brain stimulation: A study on moral decision-making in Parkinson's disease. Parkinsonism Relat Disord 2015; 21:709-16. [DOI: 10.1016/j.parkreldis.2015.04.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 03/03/2015] [Accepted: 04/13/2015] [Indexed: 01/10/2023]
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20
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Decisions, Decisions: The Neurobiology of the effects of Dopamine Replacement Therapy on Decision-Making in Parkinson’s Disease. JOURNAL OF EUROPEAN PSYCHOLOGY STUDENTS 2015. [DOI: 10.5334/jeps.cv] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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21
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Xi C, Zhu Y, Mu Y, Chen B, Dong B, Cheng H, Hu P, Zhu C, Wang K. Theory of mind and decision-making processes are impaired in Parkinson's disease. Behav Brain Res 2015; 279:226-33. [DOI: 10.1016/j.bbr.2014.11.035] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 11/16/2014] [Accepted: 11/20/2014] [Indexed: 11/26/2022]
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22
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Castrioto A, Funkiewiez A, Debû B, Cools R, Lhommée E, Ardouin C, Fraix V, Chabardès S, Robbins TW, Pollak P, Krack P. Iowa gambling task impairment in Parkinson's disease can be normalised by reduction of dopaminergic medication after subthalamic stimulation. J Neurol Neurosurg Psychiatry 2015; 86:186-90. [PMID: 24860137 DOI: 10.1136/jnnp-2013-307146] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Impulse control disorders (ICD), including pathological gambling, are common in Parkinson's disease (PD) and tend to improve after subthalamic (STN) stimulation after a marked reduction of dopaminergic medication. In order to investigate the effect of STN stimulation on impulsive decision making, we used the Iowa Gambling task (IGT). METHODS We investigated IGT performance in 20 patients with PD before STN surgery with and without dopaminergic treatment and in 24 age-matched controls. All patients underwent an extensive neuropsychological interview screening for behavioural disorders. Assessment in patients was repeated 3 months after surgery without dopaminergic treatment with and without stimulation. RESULTS Chronic antiparkinsonian treatment was drastically reduced after surgery (-74%). At baseline, on high chronic dopaminergic treatment 8/20 patients with PD presented with pathological hyperdopaminergic behaviours, which had resolved in 7/8 patients 3 months after surgery on low chronic dopaminergic treatment. Preoperative performance on the IGT was significantly impaired compared to after surgery. CONCLUSIONS Dopaminergic medication likely contributes to the impairment in decision making underlying ICDs. Deep brain stimulation allows drastic reduction of dopaminergic medication and, thus, concomitant remediation of medication-induced impairment in decision making.
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Affiliation(s)
- Anna Castrioto
- Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University, Grenoble, France INSERM, Unité 836, Grenoble Institut des Neurosciences, Grenoble, France Clinica Neurologica, Università degli Studi di Perugia, Perugia, Italy
| | - Aurélie Funkiewiez
- Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University, Grenoble, France INSERM-UPMC UMRS 975, IMMA, Fédération de Neurologie, AP-HP Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Bettina Debû
- Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University, Grenoble, France INSERM, Unité 836, Grenoble Institut des Neurosciences, Grenoble, France
| | - Roshan Cools
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging Nijmegen, Nijmegen, The Netherlands Department of Psychology, Behavioural, and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Eugénie Lhommée
- Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University, Grenoble, France INSERM, Unité 836, Grenoble Institut des Neurosciences, Grenoble, France
| | - Claire Ardouin
- Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University, Grenoble, France INSERM, Unité 836, Grenoble Institut des Neurosciences, Grenoble, France
| | - Valérie Fraix
- Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University, Grenoble, France INSERM, Unité 836, Grenoble Institut des Neurosciences, Grenoble, France
| | - Stephan Chabardès
- INSERM, Unité 836, Grenoble Institut des Neurosciences, Grenoble, France Neurosurgery Department, CHU de Grenoble, Joseph Fourier University, Grenoble, France
| | - Trevor W Robbins
- Department of Psychology, Behavioural, and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Pierre Pollak
- Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University, Grenoble, France Service de Neurologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Paul Krack
- Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University, Grenoble, France INSERM, Unité 836, Grenoble Institut des Neurosciences, Grenoble, France
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23
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Abstract
Representation of reward value involves a distributed network including cortical and subcortical structures. Because neurodegenerative illnesses target specific anatomic networks that partially overlap with the reward circuit, they would be predicted to have distinct impairments in reward processing. This review presents the existing evidence of reward processing changes in neurodegenerative diseases including mild cognitive impairment (MCI), Alzheimer's disease, frontotemporal dementia, amyotrophic lateral sclerosis (ALS), Parkinson's disease, and Huntington's disease, as well as in healthy aging. Carefully distinguishing the different aspects of reward processing (primary rewards, secondary rewards, reward-based learning, and reward-based decision-making) and using tasks that differentiate the stages of processing reward will lead to improved understanding of this fundamental process and clarify a contributing cause of behavioral change in these illnesses.
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Affiliation(s)
- David C Perry
- a Department of Neurology , University of California , San Francisco , CA , USA
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24
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Lindbergh CA, Puente AN, Gray JC, MacKillop J, Miller LS. Discounting preferences and response consistency as markers of functional ability in community-dwelling older adults. J Clin Exp Neuropsychol 2014; 36:1112-23. [DOI: 10.1080/13803395.2014.983464] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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25
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Tamburin S, Maier A, Schiff S, Lauriola MF, Di Rosa E, Zanette G, Mapelli D. Cognition and emotional decision-making in chronic low back pain: an ERPs study during Iowa gambling task. Front Psychol 2014; 5:1350. [PMID: 25505440 PMCID: PMC4243494 DOI: 10.3389/fpsyg.2014.01350] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 11/06/2014] [Indexed: 12/31/2022] Open
Abstract
Previous reports documented abnormalities in cognitive functions and decision-making (DM) in patients with chronic pain, but these changes are not consistent across studies. Reasons for these discordant findings might include the presence of confounders, variability in chronic pain conditions, and the use of different cognitive tests. The present study was aimed to add evidence in this field, by exploring the cognitive profile of a specific type of chronic pain, i.e., chronic low back pain (cLBP). Twenty four cLBP patients and 24 healthy controls underwent a neuropsychological battery and we focused on emotional DM abilities by means of Iowa gambling task (IGT). During IGT, behavioral responses and the electroencephalogram (EEG) were recorded in 12 patients and 12 controls. Event-related potentials (ERPs) were averaged offline from EEG epochs locked to the feedback presentation (4000 ms duration, from 2000 ms before to 2000 ms after the feedback onset) separately for wins and losses and the feedback-related negativity (FRN) and P300 peak-to-peak amplitudes were calculated. Among cognitive measures, cLBP patients scored lower than controls in the modified card sorting test (MCST) and the score in this test was significantly influenced by pain duration and intensity. Behavioral IGT results documented worse performance and the absence of a learning process during the test in cLBP patients compared to controls, with no effect of pain characteristics. ERPs findings documented abnormal feedback processing in patients during IGT. cLBP patients showed poor performance in the MCST and the IGT. Abnormal feedback processing may be secondary to impingement of chronic pain in brain areas involved in DM or suggest the presence of a predisposing factor related to pain chronification. These abnormalities might contribute to the impairment in the work and family settings that often cLBP patients report.
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Affiliation(s)
- Stefano Tamburin
- Section of Neurology, Department of Neurological and Movement Sciences, University of Verona Verona, Italy
| | - Alice Maier
- Section of Neurology, Department of Neurological and Movement Sciences, University of Verona Verona, Italy
| | - Sami Schiff
- Department of Medicine, University of Padova Padova, Italy
| | - Matteo F Lauriola
- Section of Neurology, Pederzoli Hospital, Peschiera del Garda Verona, Italy
| | - Elisa Di Rosa
- Department of General Psychology, University of Padova Padova, Italy
| | - Giampietro Zanette
- Section of Neurology, Pederzoli Hospital, Peschiera del Garda Verona, Italy
| | - Daniela Mapelli
- Department of General Psychology, University of Padova Padova, Italy ; Human Inspired Technologies Research Center, University of Padova Padova, Italy
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26
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Dirnberger G, Jahanshahi M. Executive dysfunction in Parkinson's disease: a review. J Neuropsychol 2014; 7:193-224. [PMID: 24007368 DOI: 10.1111/jnp.12028] [Citation(s) in RCA: 324] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 06/30/2013] [Indexed: 12/17/2022]
Abstract
Executive dysfunction can be present from the early stages of Parkinson's disease (PD). It is characterized by deficits in internal control of attention, set shifting, planning, inhibitory control, dual task performance, and on a range of decision-making and social cognition tasks. Treatment with dopaminergic medication has variable effects on executive deficits, improving some, leaving some unchanged, and worsening others. In this review, we start by defining the specific nature of executive dysfunction in PD and describe suitable neuropsychological tests. We then discuss how executive deficits relate to pathology in specific territories of the basal ganglia, consider the impact of dopaminergic treatment on executive function (EF) in this context, and review the changes in EFs with disease progression. In later sections, we summarize correlates of executive dysfunction in PD with motor performance (e.g., postural instability, freezing of gait) and a variety of psychiatric (e.g., depression, apathy) and other clinical symptoms, and finally discuss the implications of these for the patients' daily life.
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Affiliation(s)
- Georg Dirnberger
- Department of Clinical Neuroscience and Preventive Medicine, Danube University, Krems, Austria.
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27
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Schiebener J, Schulte FP, Hofmann J, Brand M. A versatile task for assessing decision-making abilities: the truck dispatcher framework. APPLIED NEUROPSYCHOLOGY-ADULT 2014; 21:241-59. [PMID: 25265306 DOI: 10.1080/09084282.2013.798735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In neuropsychological decision-making research, several different tasks are used to measure decision-making competences in patients and healthy study participants. Unfortunately, the existing tasks are often inflexible for modification, use different scenarios, and include several gambling cues. Therefore, comparisons between participants' performances in different tasks are difficult. We developed the Truck Dispatcher Framework (TDF), in which different decision-making tasks can be designed within one unitary, flexible, and real-world-oriented story line. To test the story line, TDF analogues of three standard decision-making tasks (Game of Dice Task, Probability-Associated Gambling task, Iowa Gambling Task) were developed. In three studies with brain-healthy participants, the behavior in standard decision-making tasks and the TDF analogues of those tasks were compared. Similar behaviors indicate that the TDF tasks measure decision making appropriately. Thus, the TDF is recommended for experimental and clinical research because it allows for examining decision-making competences in tasks with different demands that take place within one unitary story line.
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Affiliation(s)
- Johannes Schiebener
- a General Psychology: Cognition, University of Duisburg-Essen , Duisburg , Germany
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28
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Brand M, Schiebener J, Pertl MT, Delazer M. Know the risk, take the win: how executive functions and probability processing influence advantageous decision making under risk conditions. J Clin Exp Neuropsychol 2014; 36:914-29. [PMID: 25252799 DOI: 10.1080/13803395.2014.955783] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Recent models on decision making under risk conditions have suggested that numerical abilities are important ingredients of advantageous decision-making performance, but empirical evidence is still limited. The results of our first study show that logical reasoning and basic mental calculation capacities predict ratio processing and that ratio processing predicts decision making under risk. In the second study, logical reasoning together with executive functions predicted probability processing (numeracy and probability knowledge), and probability processing predicted decision making under risk. These findings suggest that increasing an individual's understanding of ratios and probabilities should lead to more advantageous decisions under risk conditions.
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Affiliation(s)
- Matthias Brand
- a General Psychology: Cognition , University of Duisburg-Essen , Duisburg , Germany
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29
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Schiebener J, García-Arias M, García-Villamisar D, Cabanyes-Truffino J, Brand M. Developmental changes in decision making under risk: The role of executive functions and reasoning abilities in 8- to 19-year-old decision makers. Child Neuropsychol 2014; 21:759-78. [PMID: 25027746 DOI: 10.1080/09297049.2014.934216] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Previous studies have shown that children and adolescents often tend toward risky decisions despite explicit knowledge about the potential negative consequences. This phenomenon has been suggested to be associated with the immaturity of brain areas involved in cognitive control functions. Particularly, "frontal lobe functions," such as executive functions and reasoning, mature until young adulthood and are thought to be involved in age-related changes in decision making under explicit risk conditions. We investigated 112 participants, aged 8-19 years, with a frequently used task assessing decisions under risk, the Game of Dice Task (GDT). Additionally, we administered the Modified Card Sorting Test assessing executive functioning (categorization, cognitive flexibility, and strategy maintenance) as well as the Ravens Progressive Matrices assessing reasoning. The results showed that risk taking in the GDT decreased with increasing age and this effect was not moderated by reasoning but by executive functions: Particularly, young persons with weak executive functioning showed very risky decision making. Thus, the individual maturation of executive functions, associated with areas in the prefrontal cortex, seems to be an important factor in young peoples' behavior in risky decision-making situations.
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Affiliation(s)
- Johannes Schiebener
- a Department of General Psychology: Cognition , University of Duisburg-Essen , Duisburg , Germany
| | | | - Domingo García-Villamisar
- c Department of Personality and Clinical Psychology, Faculty of Psychology , University of Madrid , Spain
| | - Javier Cabanyes-Truffino
- c Department of Personality and Clinical Psychology, Faculty of Psychology , University of Madrid , Spain.,d Department of Neurology , University Clinic of Navarra , Madrid , Spain
| | - Matthias Brand
- a Department of General Psychology: Cognition , University of Duisburg-Essen , Duisburg , Germany.,e Erwin L. Hahn Institute for Magnetic Resonance Imaging , Essen , Germany
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30
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Mapelli D, Di Rosa E, Cavalletti M, Schiff S, Tamburin S. Decision and dopaminergic system: an ERPs study of Iowa gambling task in Parkinson's disease. Front Psychol 2014; 5:684. [PMID: 25071654 PMCID: PMC4080179 DOI: 10.3389/fpsyg.2014.00684] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 06/13/2014] [Indexed: 11/13/2022] Open
Abstract
Recent researches reported behavioral and emotional impairment in Parkinson's disease (PD), even in the earliest stages. This impairment affects also decision-making and learning processes. The Iowa gambling task (IGT) is commonly used to examine the decision-making capacity. The purpose of the present study was to investigate the neural correlates of feedback evaluation in the decision-making process into a learning context, using IGT and event-related potentials (ERPs) in a group of non-demented medicated PD patients. Fifteen PD patients and 15 healthy controls were recruited for the study. PD patients were administrated a basic neuropsychological assessment oriented to exclude cognitive impairments. Both groups underwent the computerized IGT during electroencephalography (EEG) registration. To analyse ERPs, continuous EEG data were epoched within a time-window starting 1000 ms before and ending 1000 ms after feedback presentation and averaged separately for positive (i.e., win condition) and negative (i.e., loss condition) feedbacks. Behavioral data revealed a significant lower performance of PD patients (p < 0.05) compared with the controls. While controls demonstrated a correct feedback evaluation, PD patients did not show any learning, selecting more disadvantageous decks even in the last part of task. Furthermore, ERPs results revealed that controls showed a significant difference (p < 0.05) in ERPs morphology recorded after the win and the loss conditions, suggesting that positive and negative feedbacks were differently evaluated and processed. PD patients showed a different pattern: their ERPs morphology was the same for positive and negative feedback. Interestingly, our ERPs results suggest that in PD patients an incorrect evaluation of context-relevant outcomes could be the reason of a poor performance in decision-making tasks, and could explain cognitive and behavioral problems related to impulse control disorder.
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Affiliation(s)
- Daniela Mapelli
- Department of General Psychology, University of Padova Padova, Italy ; Human Inspired Technologies Research Center, University of Padova Padova, Italy
| | - Elisa Di Rosa
- Department of General Psychology, University of Padova Padova, Italy
| | - Matteo Cavalletti
- Department of General Psychology, University of Padova Padova, Italy
| | - Sami Schiff
- Department of Medicine, University of Padova Padova, Italy
| | - Stefano Tamburin
- Department of Neurological and Movement Sciences, Neurology Section, University of Verona Verona, Italy
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Parkinson's disease patients with subthalamic stimulation and carers judge quality of life differently. Parkinsonism Relat Disord 2014; 20:514-9. [DOI: 10.1016/j.parkreldis.2014.02.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 02/03/2014] [Accepted: 02/10/2014] [Indexed: 11/19/2022]
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What are people with Parkinson's disease really impaired on when it comes to making decisions? A meta-analysis of the evidence. Neurosci Biobehav Rev 2013; 37:2836-46. [DOI: 10.1016/j.neubiorev.2013.10.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 10/02/2013] [Accepted: 10/09/2013] [Indexed: 11/17/2022]
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Buelow MT, Okdie BM, Blaine AL. Seeing the forest through the trees: improving decision making on the Iowa gambling task by shifting focus from short- to long-term outcomes. Front Psychol 2013; 4:773. [PMID: 24151485 PMCID: PMC3798868 DOI: 10.3389/fpsyg.2013.00773] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 10/01/2013] [Indexed: 11/13/2022] Open
Abstract
Introduction: The present study sought to examine two methods by which to improve decision making on the Iowa Gambling Task (IGT): inducing a negative mood and providing additional learning trials. Method: In the first study, 194 undergraduate students [74 male; Mage = 19.44 (SD = 3.69)] were randomly assigned to view a series of pictures to induce a positive, negative, or neutral mood immediately prior to the IGT. In the second study, 276 undergraduate students [111 male; Mage = 19.18 (SD = 2.58)] completed a delay discounting task and back-to-back administrations of the IGT. Results: Participants in an induced negative mood selected more from Deck C during the final trials than those in an induced positive mood. Providing additional learning trials resulted in better decision making: participants shifted their focus from the frequency of immediate gains/losses (i.e., a preference for Decks B and D) to long-term outcomes (i.e., a preference for Deck D). In addition, disadvantageous decision making on the additional learning trials was associated with larger delay discounting (i.e., a preference for more immediate but smaller rewards). Conclusions: The present results indicate that decision making is affected by negative mood state, and that decision making can be improved by increasing the number of learning trials. In addition, the current results provide evidence of a relationship between performance on the IGT and on a separate measure of decision making, the delay discounting task. Moreover, the present results indicate that improved decision making on the IGT can be attributed to shifting focus toward long-term outcomes, as evidenced by increased selections from advantageous decks as well as correlations between the IGT and delay discounting task. Implications for the assessment of decision making using the IGT are discussed.
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Affiliation(s)
- Melissa T Buelow
- Department of Psychology, The Ohio State University Newark Newark, OH, USA
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Chen X, Zhu C, Li J, Qiu L, Zhang L, Yu F, Ye R, Zhang J, Wang K. Dissociation of decision making under ambiguity and decision making under risk in breast cancer patients receiving adjuvant chemotherapy: A neuropsychological study. Brain Res 2013; 1533:63-72. [DOI: 10.1016/j.brainres.2013.08.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 08/02/2013] [Accepted: 08/06/2013] [Indexed: 01/17/2023]
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Florin E, Müller D, Pfeifer J, Barbe MT, Fink GR, Timmermann L. Subthalamic stimulation modulates self-estimation of patients with Parkinson's disease and induces risk-seeking behaviour. ACTA ACUST UNITED AC 2013; 136:3271-81. [PMID: 24071530 DOI: 10.1093/brain/awt241] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Patients with Parkinson's disease with deep brain stimulation in the subthalamic nucleus postoperatively often display higher impulsivity and therefore may experience difficulties in social interactions. Here, we examined social interactions of patients with Parkinson's disease with and without deep brain stimulation in the subthalamic nucleus in competitive situations. We hypothesized altered self-estimation and risk-seeking behaviour in this patient group induced by deep brain stimulation in the subthalamic nucleus. To test the hypothesis, an experimental setting was used in which participants performed a calculation task and chose their preferred compensation. Based on their actual calculation performance, more patients with Parkinson's disease with deep brain stimulation chose a competitive tournament compensation. Assuming rational behaviour, this self-selection pattern reflects increased risk tolerance. Since patients who performed in the lowest quartile chose the tournament option, the data suggest that deep brain stimulation in the subthalamic nucleus results in a loss of the correct reference frame against which patients with Parkinson's disease evaluate their performance. The stimulation-induced combination of overestimation of their own performance, increased risk-taking, and preference for competitive environments despite poor performance is likely to impact considerably on the patients' social and work life.
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Affiliation(s)
- Esther Florin
- 1 Department of Neurology, University Hospital Cologne, Germany
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36
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Buelow MT, Frakey LL, Grace J, Friedman JH. The Contribution of Apathy and Increased Learning Trials to Risky Decision-Making in Parkinson's Disease. Arch Clin Neuropsychol 2013; 29:100-9. [PMID: 23969088 DOI: 10.1093/arclin/act065] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Melissa T Buelow
- Department of Psychology, The Ohio State University Newark, Newark, OH, USA
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Symmonds M, Wright ND, Fagan E, Dolan RJ. Assaying the effect of levodopa on the evaluation of risk in healthy humans. PLoS One 2013; 8:e68177. [PMID: 23844168 PMCID: PMC3700857 DOI: 10.1371/journal.pone.0068177] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 05/26/2013] [Indexed: 12/04/2022] Open
Abstract
In humans, dopamine is implicated in reward and risk-based decision-making. However, the specific effects of dopamine augmentation on risk evaluation are unclear. Here we sought to measure the effect of 100 mg oral levodopa, which enhances synaptic release of dopamine, on choice behaviour in healthy humans. We use a paradigm without feedback or learning, which solely isolates effects on risk evaluation. We present two studies (n = 20; n = 20) employing a randomised, placebo-controlled, within-subjects design. We manipulated different dimensions of risk in a controlled economic paradigm. We test effects on risk-reward tradeoffs, assaying both aversion to variance (the spread of possible outcomes) and preference for relative losses and gains (asymmetry of outcomes - skewness), dissociating this from potential non-specific effects on choice randomness using behavioural modelling. There were no systematic effects of levodopa on risk attitudes, either for variance or skewness. However, there was a drift towards more risk-averse behaviour over time, indicating that this paradigm was sensitive to detect changes in risk-preferences. These findings suggest that levodopa administration does not change the evaluation of risk. One possible reason is that dopaminergic influences on decision making may be due to changing the response to reward feedback.
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Affiliation(s)
- Mkael Symmonds
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, United Kingdom.
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Gescheidt T, Mareček R, Mikl M, Czekóová K, Urbánek T, Vaníček J, Shaw DJ, Bareš M. Functional anatomy of outcome evaluation during Iowa Gambling Task performance in patients with Parkinson’s disease: an fMRI study. Neurol Sci 2013; 34:2159-66. [PMID: 23609460 DOI: 10.1007/s10072-013-1439-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Accepted: 04/10/2013] [Indexed: 02/05/2023]
Affiliation(s)
- Tomáš Gescheidt
- CEITEC-Central European Institute of Technology, Behavioral and Social Neuroscience Research Group, Masaryk University, University Campus Bohunice, Building A4, Brno, Czech Republic
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39
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Rascovsky K, Grossman M. Clinical diagnostic criteria and classification controversies in frontotemporal lobar degeneration. Int Rev Psychiatry 2013; 25:145-58. [PMID: 23611345 PMCID: PMC3906583 DOI: 10.3109/09540261.2013.763341] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Frontotemporal lobar degeneration (FTLD) can manifest as a spectrum of clinical syndromes, ranging from behavioural impairment to language or motor dysfunction. Recently, revised diagnostic criteria have been proposed for the behavioural and progressive aphasia syndromes associated with frontotemporal degeneration. The present review will summarize these diagnostic guidelines and highlight some lingering controversies in the classification of FTLD clinical syndromes. We will discuss common tools and methods used to identify the insidious changes of behavioural variant frontotemporal dementia (bvFTD), the value of new, patient-based tasks of orbitofrontal function, and the issue of a benign or 'phenocopy' variant of bvFTD. With regard to primary progressive aphasia (PPA), we will discuss the scope of the semantic disorder in semantic-variant PPA, the nature of the speech disorder in non-fluent, agrammatic PPA, and the preliminary utility of a logopenic PPA classification.
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Affiliation(s)
- Katya Rascovsky
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
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40
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Orbital and ventromedial prefrontal cortex functioning in Parkinson’s disease: Neuropsychological evidence. Brain Cogn 2012; 79:23-33. [DOI: 10.1016/j.bandc.2012.02.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 02/02/2012] [Accepted: 02/03/2012] [Indexed: 12/15/2022]
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Delazer M, Högl B, Zamarian L, Wenter J, Ehrmann L, Gschliesser V, Brandauer E, Poewe W, Frauscher B. Decision making and executive functions in REM sleep behavior disorder. Sleep 2012; 35:667-73. [PMID: 22547893 DOI: 10.5665/sleep.1828] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES This study was designed to assess decision making and executive functions in patients with idiopathic REM sleep behavior disorder (iRBD). IRBD is often seen as an early sign of later evolving neurodegenerative disease, most importantly Parkinson disease (PD) and Lewy body dementia (DLB). It has been proposed that iRBD patients show a cognitive profile similar to patients with PD. DESIGN All participants performed an extensive test battery tapping executive functions as well as the IOWA gambling task, which measures decision making under ambiguity. SETTING University hospital sleep disorders center. PARTICIPANTS 16 iRBD patients and 45 age- and education-matched controls. INTERVENTION N.A. MEASUREMENTS AND RESULTS Compared with controls, iRBD patients showed disadvantageous decision making under ambiguity and did not learn by feedback over the task. IRBD patients' decision pattern was characterized by the lack of a consistent strategy, as indicated by frequent shifts between the single choices. A high proportion of iRBD patients (75%) showed random performance or worse even at the end of the task. No group differences were found in tasks assessing information sampling, flexibility and categorization, problem solving, and impulsivity. CONCLUSIONS As suggested by the present investigation, iRBD patients may show difficulties in decision making under ambiguity in a stage when other cognitive functions are relatively well preserved. Whether this is driven by subgroups of patients prone to develop PD or DLB has to be assessed by follow-up investigations.
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Affiliation(s)
- Margarete Delazer
- Department of Neurology, Innsbruck, Medical University, Innsbruck, Austria
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42
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Gescheidt T, Czekóová K, Urbánek T, Mareček R, Mikl M, Kubíková R, Telecká S, Andrlová H, Husárová I, Bareš M. Iowa Gambling Task in patients with early-onset Parkinson’s disease: strategy analysis. Neurol Sci 2012; 33:1329-35. [PMID: 22526761 DOI: 10.1007/s10072-012-1086-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Accepted: 03/27/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Tomáš Gescheidt
- Behavioral and Social Neuroscience Research Group, CEITEC-Central European Institute of Technology, Masaryk University, Brno, Czech Republic
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43
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Sasai T, Miyamoto T, Miyamoto M, Iwanami M, Abe T, Matsuura M, Inoue Y. Impaired decision-making in idiopathic REM sleep behavior disorder. Sleep Med 2012; 13:301-6. [PMID: 22285107 DOI: 10.1016/j.sleep.2011.09.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 09/04/2011] [Accepted: 09/06/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND Patients with REM sleep behavior disorder (RBD) frequently develop Parkinson's disease (PD), which can impair decision-making ability. This study was undertaken to investigate decision-making ability and its relation to olfactory function in patients with idiopathic RBD. METHODS This study used the Iowa Gambling Task (IGT) and the Sniffin' Stick Test for examination of 38 patients with idiopathic RBD (iRBD) and 34 age-matched healthy control subjects (HC). Associations between these test results and other clinical RBD variables were also assessed. RESULTS Total IGT score and Sniffin' Stick Test scores were significantly lower in the iRBD group than in the HC group. The iRBD group IGT scores in the first, third, and final blocks were significantly lower than those of the HC group. In the iRBD group, no association was found between the total IGT score and the Sniffin' Stick Test score or any clinical RBD variable. CONCLUSIONS Impaired decision-making associated with iRBD can herald PD. However, decision-making disability is thought to appear irrespective of olfactory dysfunction and progression of RBD pathology.
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Affiliation(s)
- Taeko Sasai
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
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44
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Pignatti R, Brioschi A, Mauro A, Zamarian L, Wenter J, Semenza C. Selective IGT decision-making impairment in a patient with juvenile Parkinson's disease and pathological gambling: a role for dopaminergic therapy? Neurocase 2012; 18:503-13. [PMID: 22224448 DOI: 10.1080/13554794.2011.633529] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The orbitofrontal cortex and the dopaminergic system are structures involved in managing impulsivity and sensibility to reinforcements, and both are typically impaired in Parkinson's disease (PD). Also, l-DOPA treatment can contribute to the development of the 'Dopamine Dysregulation Syndrome', a syndrome that can influence the patients' personality and lead to risk-taking behaviors. In this study, we describe the case of a 42-year-old woman (LT) affected by juvenile PD, treated with both l-DOPA and dopamine agonists, who showed a sudden onset of pathological gambling (PG), as the only neuropsychiatric symptom. We assessed LT with a full neuropsychological battery and the Iowa Gambling Task (IGT), in order to describe her specific failure in decision making. LT's performance on the IGT is compared with that of 15 non-demented PD patients under therapy with dopamine agonists and no behavioral dysregulations and with that of 16 age- and education-matched healthy subjects. Results showed fully preserved memory, executive functions, and reasoning abilities for LT, but a remarkable and stable impairment in the IGT. Performance of LT on the IGT is significantly lower than that of both control groups. This case shows, for the first time, that high cognitive functioning and preserved executive functions are no guarantee for advantageous decision making, and that the onset of PG is consistent with selective orbitofrontal disruption and side-effects of dopamine agonist therapy. It is also showed that the IGT is a useful neuropsychological device to detect specific risk-taking behaviors, which compromise functioning in real life.
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Affiliation(s)
- Riccardo Pignatti
- Psychology Laboratory, Istituto Auxologico Italiano IRCCS Ospedale S. Giuseppe, Piancavallo, Italy.
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45
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Antonelli F, Ray N, Strafella AP. Impulsivity and Parkinson's disease: more than just disinhibition. J Neurol Sci 2011; 310:202-7. [PMID: 21683964 PMCID: PMC3440306 DOI: 10.1016/j.jns.2011.06.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 05/30/2011] [Accepted: 06/01/2011] [Indexed: 11/29/2022]
Abstract
In the last few years it has become clear that impulsivity is a complex behaviour composed of different domains and dependent on different neural networks. The proposed pathogenetic mechanisms for the emergence of impulsivity disorders in Parkinson's Disease (PD) can be broadly separated into three potentially interacting processes: the contribution of premorbid susceptibility to impulsivity, the contribution of the disease itself to the behaviour and the potential contribution of therapeutic agents. Growing evidence suggests that dopamine and the subthalamic nucleus are playing a certain role in the pathophysiology of different aspects of impulsivity. In this review, we summarise the main concepts defining various components of impulsivity both in healthy subjects and patients affected by PD.
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Affiliation(s)
- Francesca Antonelli
- Toronto Western Research Institute and Hospital, UHN, University of Toronto, Toronto, Canada
- PET Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Nicola Ray
- Toronto Western Research Institute and Hospital, UHN, University of Toronto, Toronto, Canada
- PET Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Antonio P. Strafella
- Toronto Western Research Institute and Hospital, UHN, University of Toronto, Toronto, Canada
- PET Imaging Centre, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
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46
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47
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Schiebener J, Zamarian L, Delazer M, Brand M. Executive functions, categorization of probabilities, and learning from feedback: What does really matter for decision making under explicit risk conditions? J Clin Exp Neuropsychol 2011; 33:1025-39. [DOI: 10.1080/13803395.2011.595702] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Johannes Schiebener
- a General Psychology: Cognition, University of Duisburg-Essen , Duisburg, Germany
| | - Laura Zamarian
- b Clinical Department of Neurology , Innsbruck Medical University , Innsbruck, Austria
| | - Margarete Delazer
- b Clinical Department of Neurology , Innsbruck Medical University , Innsbruck, Austria
| | - Matthias Brand
- a General Psychology: Cognition, University of Duisburg-Essen , Duisburg, Germany
- c Erwin L. Hahn Institute for Magnetic Resonance Imaging , Essen, Germany
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48
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Bayard S, Yu H, Langenier MC, Carlander B, Dauvilliers Y. Decision making in restless legs syndrome. Mov Disord 2011; 25:2634-40. [PMID: 20669306 DOI: 10.1002/mds.23326] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The dopamine system is implicated in reward-based decision making with explicit information (decision making under risk) and implicit probabilities (decision making under ambiguity). Although the pathophysiology of restless legs syndrome (RLS) is not yet fully understood, the genetic factors, iron status, and dopaminergic system are thought to play a role. RLS provides an opportunity to test the dopaminergic hypothesis in a drug-free population and to characterize reward processing using decision-making paradigms. We investigated impulsivity, impulse control disorders, and decision making in 50 untreated patients with primary RLS compared with 60 sex- and age-matched normal controls using one night of polysomnography recording, a structured psychiatric interview, and questionnaires (RLS Severity Scale, Beck Depression Inventory, and Urgency Premeditation Perseverance Impulsive Behavior Scale). Subjects performed the Iowa Gambling Task to assess decision making under ambiguity and the Game of Dice Task to assess decision making under risk. Patients with RLS showed selective changes in decision making on the Iowa Gambling Task and normal decision making on the Game of Dice Task compared with controls. Patients with RLS had greater depressive symptoms than controls, but no difference was found in impulsivity, impulse control disorders, or addictive behaviors. Clinical and polysomnographic variables were unrelated to decision-making performance. Results indicate reduced decision-making performance under ambiguity in drug-free patients with RLS. From a clinical perspective, when using dopaminergic medication to treat RLS, patients with abnormal baseline behaviors should be closely monitored.
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Affiliation(s)
- Sophie Bayard
- Department of Neurology, Gui de Chauliac Hospital, Montpellier 34295, France
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49
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Poletti M, Cavedini P, Bonuccelli U. Iowa Gambling Task in Parkinson's Disease. J Clin Exp Neuropsychol 2010; 33:395-409. [PMID: 21140314 DOI: 10.1080/13803395.2010.524150] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Michele Poletti
- a Neurology Unit, Unità Sanitaria Locale of Viareggio , Viareggio, Italy
- b Department of Neuroscience , University of Pisa , Pisa, Italy
| | - Paolo Cavedini
- c Department of Clinical Neurosciences , Villa San Benedetto Hospital, Hermanas Hospitalarias , Albese con Cassano, Italy
| | - Ubaldo Bonuccelli
- a Neurology Unit, Unità Sanitaria Locale of Viareggio , Viareggio, Italy
- b Department of Neuroscience , University of Pisa , Pisa, Italy
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50
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What do cognitively intact older people think about the use of electronic tracking devices for people with dementia? A preliminary analysis. Int Psychogeriatr 2010; 22:1301-9. [PMID: 20594387 DOI: 10.1017/s1041610210001316] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The issue of using advanced tracking technologies such as Global Positioning Systems (GPS) is part of a wider debate on the acceptability of assistive technology to older people with dementia. The use of GPS can enhance the personal safety of older people by alerting caregivers to potential dangers or adverse events that might threaten the individual's health and safety, but at the same time it raises ethical concerns. This study examines the attitudes of cognitively intact older people toward the use of tracking devices for people with dementia. METHODS The analysis is based on quantitative data from a convenience sample (n = 42) and qualitative data gathered from two focus groups of cognitively intact older people in Israel. RESULTS Whereas cognitively intact older people clearly differentiate between themselves and people with dementia, they support the use of tracking devices when dementia is either formally diagnosed or its signs are evident. They value the safety of people with dementia above preserving their autonomy. Although they perceive the decision to use tracking devices as an intra-family issue, they expect guidance from professional caregivers of people with dementia. The acceptability of tracking devices is dependent on their appropriate weight, size and ease of use. CONCLUSIONS Cognitively intact older people favor the idea of tracking people with dementia. To facilitate family decision-making on the use of tracking devices, structured meetings guided by professionals and including persons with dementia and their family caregivers are suggested.
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