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Colautti L, Iannello P, Silveri MC, Antonietti A. Decision making in Parkinson's disease: An analysis of the studies using the Iowa Gambling Task. Eur J Neurosci 2021; 54:7513-7549. [PMID: 34655122 PMCID: PMC9299644 DOI: 10.1111/ejn.15497] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 10/02/2021] [Accepted: 10/11/2021] [Indexed: 12/21/2022]
Abstract
In Parkinson's disease (PD) impairments in decision making can occur, in particular because of the tendency toward risky and rewarding options. The Iowa Gambling Task has been widely used to investigate decision processes involving these options. The task assesses the ability to manage risk and to learn from feedback. The present paper aims at critically examining those studies in which this task has been administered to PD patients, in order to understand possible anomalies in patients' decision processes and which variables are responsible for that. A meta‐analysis has been conducted as well. Features of the task, sociodemographic and clinical aspects (including daily drugs intake), cognitive conditions and emotional disorders of the patients have been taken into account. Neural correlates of decision‐making competences were considered. It emerged that PD patients show a trend of preference toward risky choices, probably due to an impairment in anticipating the unrewarding consequences or to an insensitiveness to punishment. The possible role played by dopamine medications in decision making under uncertain conditions, affecting basal ganglia and structures involved in the limbic loop, was discussed. Attention has been focused on some aspects that need to be investigated in further research, in order to delve into this issue and promote patients' quality of life.
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Affiliation(s)
- Laura Colautti
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Paola Iannello
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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Landmeyer NC, Dzionsko I, Brockhoff L, Wiendl H, Domes G, Bölte J, Krämer J, Meuth SG, Johnen A. The Agony of Choice? Preserved Affective Decision Making in Early Multiple Sclerosis. Front Neurol 2020; 11:914. [PMID: 32982932 PMCID: PMC7492612 DOI: 10.3389/fneur.2020.00914] [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: 03/04/2020] [Accepted: 07/16/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Cognitive impairment (CI) is an early and frequent symptom of multiple sclerosis (MS). Likewise, affective symptoms (e.g., depression and anxiety) and alterations in the processing of emotional stimuli have been frequently reported. Thus, abilities that integrate affective and cognitive processes such as decision making (DM) based on affective feedback are potentially valuable early diagnostic markers for MS. The available research on this topic, however, is still inconclusive and suffers from methodological issues. Methods: We compared DM ability in a clinically homogeneous cohort of 24 patients with early relapsing-remitting MS (RRMS) and 59 age-matched healthy controls (HCs). A modified version of the Iowa gambling task (IGT) allowed us to control for individual differences in search strategies during the risk exploration phase. Besides standard IGT measures (netscore, obtained play money, and learning index), we also examined reaction times and post-error slowing (PES) patterns as a proxy for abnormalities in the processing of affective feedback. Results: The performance of patients did not significantly deviate from HCs in any standard parameter of the modified IGT. Furthermore, although RRMS patients reacted significantly slower than HCs overall, we found similar patterns of PES in both groups, suggesting similarly efficient processing of affective feedback. Conclusion: We conclude that there is no specific deficit in affective feedback processing in early RRMS. Previous findings of IGT impairments in this patient group may thus not represent a genuine deficit in affective DM but rather be related to sample characteristics, general CI, and/or differences in individual search strategies. Future research should explore the potential influence of lesion volumes and locations on DM ability by employing brain imaging techniques.
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Affiliation(s)
- Nils C Landmeyer
- Department of Neurology With Institute of Translational Neurology, University Hospital Münster, Westfälische-Wilhelms-University Münster, Münster, Germany
| | - Inga Dzionsko
- Department of Neurology With Institute of Translational Neurology, University Hospital Münster, Westfälische-Wilhelms-University Münster, Münster, Germany.,Department of Biological and Clinical Psychology, University of Trier, Trier, Germany
| | - Laura Brockhoff
- Department of Neurology With Institute of Translational Neurology, University Hospital Münster, Westfälische-Wilhelms-University Münster, Münster, Germany.,Department of Psychology, Westfälische-Wilhelms-University Münster, Münster, Germany
| | - Heinz Wiendl
- Department of Neurology With Institute of Translational Neurology, University Hospital Münster, Westfälische-Wilhelms-University Münster, Münster, Germany
| | - Gregor Domes
- Department of Biological and Clinical Psychology, University of Trier, Trier, Germany
| | - Jens Bölte
- Department of Psychology, Westfälische-Wilhelms-University Münster, Münster, Germany
| | - Julia Krämer
- Department of Neurology With Institute of Translational Neurology, University Hospital Münster, Westfälische-Wilhelms-University Münster, Münster, Germany
| | - Sven G Meuth
- Department of Neurology With Institute of Translational Neurology, University Hospital Münster, Westfälische-Wilhelms-University Münster, Münster, Germany
| | - Andreas Johnen
- Department of Neurology With Institute of Translational Neurology, University Hospital Münster, Westfälische-Wilhelms-University Münster, Münster, Germany
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