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Colautti L, Iannello P, Silveri MC, Antonietti A. Decision-making under ambiguity and risk and executive functions in Parkinson's disease patients: A scoping review of the studies investigating the Iowa Gambling Task and the Game of Dice. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:1225-1243. [PMID: 37198383 PMCID: PMC10545597 DOI: 10.3758/s13415-023-01106-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/19/2023]
Abstract
Evidence shows that patients affected by Parkinson's disease (PD) display the tendency toward making risky choices. This is due, at least in part, to the pathophysiological characteristics of the disease that affects neural areas underlying decision making (DM), in which a pivotal role is played by nonmotor corticostriatal circuits and dopamine. Executive functions (EFs), which can be impaired by PD as well, may sustain optimal choices in DM processes. However, few studies have investigated whether EFs can support PD patients to make good decisions. Adopting the scoping review approach, the present article is designed to deepen the cognitive mechanisms of DM under conditions of ambiguity and risk (that are conditions common to everyday life decisions) in PD patients without impulse control disorders. We focused our attention on the Iowa Gambling Task and the Game of Dice Task, because they are the most commonly used and reliable tasks to assess DM under ambiguity and under risk, respectively, and analyzed the performances in such tasks and their relationships with EFs tests in PD patients. The analysis supported the relationships between EFs and DM performance, especially when a higher cognitive load is required to make optimal decisions, as it happens under conditions of risk. Possible knowledge gaps and further research directions are suggested to better understand DM mechanisms in PD sustaining patients' cognitive functioning and preventing negative consequences in everyday life derived from suboptimal decisions.
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Affiliation(s)
- Laura Colautti
- Department of Psychology, Catholic University of the Sacred Heart, Laura Colautti, Largo A. Gemelli, 1, 20123 Milan, Italy
| | - Paola Iannello
- Department of Psychology, Catholic University of the Sacred Heart, Laura Colautti, Largo A. Gemelli, 1, 20123 Milan, Italy
| | - Maria Caterina Silveri
- Department of Psychology, Catholic University of the Sacred Heart, Laura Colautti, Largo A. Gemelli, 1, 20123 Milan, Italy
| | - Alessandro Antonietti
- Department of Psychology, Catholic University of the Sacred Heart, Laura Colautti, Largo A. Gemelli, 1, 20123 Milan, Italy
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Decombe L, Henry A, Decombe R, Tir M, Doé de Maindreville A, Galland Hairabedian L, Kaladjian A, Raucher-Chéné D. "Accidental, really?" Attributional bias in patients with Parkinson's disease. Parkinsonism Relat Disord 2021; 95:18-22. [PMID: 34959046 DOI: 10.1016/j.parkreldis.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/03/2021] [Accepted: 12/20/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Among the cognitive domains impaired in Parkinson's disease (PD), social cognition has received particular attention in recent years. Nevertheless, attributional bias, a social-cognitive subdomain, has not yet been studied in this population, despite its potential relationship with neuropsychiatric symptoms, and despite the possibility that deep-brain stimulation of the subthalamic nucleus, an effective treatment for disabling motor symptoms, worsens cognitive impairment. The present study therefore compared the attributional bias of patients with PD (stimulated and nonstimulated subgroups) with that of controls. It also explored the potential correlations between patients' attributional bias and their clinical scores. METHODS Thirty-two patients with PD (12 stimulated and 20 nonstimulated) were recruited and matched with 32 healthy controls. Attributional bias was assessed using the Ambiguous Intentions Hostility Questionnaire, which yields three subscores: Hostility Bias, Aggression Bias, and Blame. Depressive symptoms (Hamilton Rating Scale for Depression), paranoid thoughts (Paranoia Scale), global cognition (Montreal Cognitive Assessment), and social functioning (Social Functioning Questionnaire) were also assessed. RESULTS Patients exhibited more hostile and aggressive biases than controls, especially in ambiguous situations. Stimulated patients had greater hostility and aggression biases and a higher blame score than controls in accidental situations. No significant differences were observed between stimulated and nonstimulated patients. CONCLUSION To our knowledge, this is the first study to have assessed attributional bias in patients with PD and explored the impact of deep-brain stimulation on this particular subdomain of social cognition. Results suggest that patients exhibit attributional bias, and this impairment may be exacerbated in stimulated patients.
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Affiliation(s)
- Léa Decombe
- Pôle de Psychiatrie Universitaire, CHU de Reims, EPSMM, Reims, France.
| | - Audrey Henry
- Pôle de Psychiatrie Universitaire, CHU de Reims, EPSMM, Reims, France; Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571, Reims Cedex, France
| | - René Decombe
- Service de Neurologie, Centre Hospitalier « Simone Veil », Troyes, France
| | - Mélissa Tir
- Service de Neurologie, CHU Amiens Site Sud, Amiens, France
| | | | - Lou Galland Hairabedian
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571, Reims Cedex, France
| | - Arthur Kaladjian
- Pôle de Psychiatrie Universitaire, CHU de Reims, EPSMM, Reims, France; Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571, Reims Cedex, France
| | - Delphine Raucher-Chéné
- Pôle de Psychiatrie Universitaire, CHU de Reims, EPSMM, Reims, France; Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571, Reims Cedex, France
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Irmen F, Horn A, Meder D, Neumann WJ, Plettig P, Schneider GH, Siebner HR, Kühn AA. Sensorimotor subthalamic stimulation restores risk-reward trade-off in Parkinson's disease. Mov Disord 2018; 34:366-376. [PMID: 30485537 DOI: 10.1002/mds.27576] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 09/26/2018] [Accepted: 10/11/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND STN-DBS effectively treats motor symptoms of advanced PD. Nonmotor cognitive symptoms, such as impaired impulse control or decision making, may either improve or worsen with DBS. A potential mediating factor of DBS-induced modulation of cognition is the electrode position within the STN with regard to functional subareas of parallel motor, cognitive, and affective basal ganglia loops. However, to date, the volume of tissue activated and weighted stimulation of STN motor versus nonmotor territories are yet to be linked to differential DBS effects on cognition. OBJECTIVES We aim to investigate whether STN-DBS influences risk-reward trade-off decisions and analyze its dependency on electrode placement. METHODS Seventeen PD patients ON and OFF STN-DBS and 17 age-matched healthy controls conducted a sequential decision-making task with escalating risk and reward. We computed the effect of STN-DBS on risk-reward trade-off decisions, localized patients' bilateral electrodes, and analyzed the predictive value of volume of tissue activated in STN motor and nonmotor territories on behavioral change. RESULTS We found that STN-DBS not only improves PD motor symptoms, but also normalizes overly risk-averse decision behavior in PD. Intersubject variance in electrode location could explain this behavioral change. Specifically, if STN-DBS activated preferentially STN motor territory, patients' risk-reward trade-off decisions more resembled those of healthy controls. CONCLUSIONS Our findings support the notion of convergence of different functional circuits within the STN and imply a positive effect of well-placed STN-DBS on nonmotor cognitive functioning in PD. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Friederike Irmen
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Biological Psychology and Cognitive Neuroscience, Freie Universität Berlin, Berlin, Germany
| | - Andreas Horn
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - David Meder
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Wolf-Julian Neumann
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Philip Plettig
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Gerd-Helge Schneider
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Andrea A Kühn
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Deutsches Zentrum für Neurodegenerative Erkrankungen, Berlin, Germany
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Sepúlveda M, Fernández-Diez B, Martínez-Lapiscina EH, Llufriu S, Sola-Valls N, Zubizarreta I, Blanco Y, Saiz A, Levy D, Glimcher P, Villoslada P. Impairment of decision-making in multiple sclerosis: A neuroeconomic approach. Mult Scler 2016; 23:1762-1771. [PMID: 27903935 DOI: 10.1177/1352458516682103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the decision-making impairment in patients with multiple sclerosis (MS) and how they relate to other cognitive domains. METHODS We performed a cross-sectional analysis in 84 patients with MS, and 21 matched healthy controls using four tasks taken from behavioral economics: (1) risk preferences, (2) choice consistency, (3) delay of gratification, and (4) rate of learning. All tasks were conducted using real-world reward outcomes (food or money) in different real-life conditions. Participants underwent cognitive examination using the Brief Repeatable Battery-Neuropsychology. RESULTS Patients showed higher risk aversion (general propensity to choose the lottery was 0.51 vs 0.64, p = 0.009), a trend to choose more immediate rewards over larger but delayed rewards ( p = 0.108), and had longer reactions times ( p = 0.033). Choice consistency and learning rates were not different between groups. Progressive patients chose slower than relapsing patients. In relation to general cognitive impairments, we found correlations between impaired decision-making and impaired verbal memory ( r = 0.29, p = 0.009), visual memory ( r = -0.37, p = 0.001), and reduced processing speed ( r = -0.32, p = 0.001). Normalized gray matter volume correlated with deliberation time ( r = -0.32, p = 0.005). CONCLUSION Patients with MS suffer significant decision-making impairments, even at the early stages of the disease, and may affect patients' quality and social life.
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Affiliation(s)
- Maria Sepúlveda
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Begoña Fernández-Diez
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Elena H Martínez-Lapiscina
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Sara Llufriu
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Nuria Sola-Valls
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Irati Zubizarreta
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Yolanda Blanco
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Albert Saiz
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Dino Levy
- Coller School of Management and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Paul Glimcher
- Center for Neural Science, New York University, New York, NY, USA
| | - Pablo Villoslada
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain/Department of Neurology, University of California-San Francisco (UCSF), San Francisco, CA, USA
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Gupta R, Kim C, Agarwal N, Lieber B, Monaco EA. Understanding the Influence of Parkinson Disease on Adolf Hitler's Decision-Making during World War II. World Neurosurg 2015; 84:1447-52. [PMID: 26093359 DOI: 10.1016/j.wneu.2015.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 06/06/2015] [Accepted: 06/09/2015] [Indexed: 01/29/2023]
Abstract
Parkinson disease (PD) is a common neurodegenerative disorder characterized by the presence of Lewy bodies and a reduction in the number of dopaminergic neurons in the substantia nigra of the basal ganglia. Common symptoms of PD include a reduction in control of voluntary movements, rigidity, and tremors. Such symptoms are marked by a severe deterioration in motor function. The causes of PD in many cases are unknown. PD has been found to be prominent in several notable people, including Adolf Hitler, the Chancellor of Germany and Führer of Nazi Germany during World War II. It is believed that Adolf Hitler suffered from idiopathic PD throughout his life. However, the effect of PD on Adolf Hitler's decision making during World War II is largely unknown. Here we examine the potential role of PD in shaping Hitler's personality and influencing his decision-making. We purport that Germany's defeat in World War II was influenced by Hitler's questionable and risky decision-making and his inhumane and callous personality, both of which were likely affected by his condition. Likewise his paranoid disorder marked by intense anti-Semitic beliefs influenced his treatment of Jews and other non-Germanic peoples. We also suggest that the condition played an important role in his eventual political decline.
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Affiliation(s)
- Raghav Gupta
- Department of Biology, College of New Jersey, Ewing, New Jersey, USA
| | - Christopher Kim
- Department of Biology, College of New Jersey, Ewing, New Jersey, USA
| | - Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
| | - Bryan Lieber
- Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Edward A Monaco
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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