Decision-making in Parkinson’s disease patients with and without pathological gambling
Article first published online: 23 SEP 2009
© 2009 The Author(s). Journal compilation © 2009 EFNS
European Journal of Neurology
Volume 17, Issue 1, pages 97–102, January 2010
How to Cite
Rossi, M., Gerschcovich, E. R., De Achaval, D., Perez-Lloret, S., Cerquetti, D., Cammarota, A., Inés Nouzeilles, M., Fahrer, R., Merello, M. and Leiguarda, R. (2010), Decision-making in Parkinson’s disease patients with and without pathological gambling. European Journal of Neurology, 17: 97–102. doi: 10.1111/j.1468-1331.2009.02792.x
- Issue published online: 18 DEC 2009
- Article first published online: 23 SEP 2009
- Received 12 February 2009 Accepted 25 June 2009
Vol. 18, Issue 5, 797, Article first published online: 15 APR 2011
- impulse control disorders;
- Iowa gambling task;
- movement disorders;
- Parkinson’s disease;
- pathological gambling;
- social behavior;
- ventromedial prefrontal cortex
Background and purpose: Pathological gambling (PG) in Parkinson’s disease (PD) is a frequent impulse control disorder associated mainly with dopamine replacement therapy. As impairments in decision-making were described independently in PG and PD, the objective of this study was to assess decision-making processes in PD patients with and without PG.
Methods: Seven PD patients with PG and 13 age, sex, education and disease severity matched PD patients without gambling behavior were enrolled in the study. All patients were assessed with a comprehensive neuropsychiatric and cognitive evaluation, including tasks used to assess decision-making abilities under ambiguous or risky situations, like the Iowa Gambling Task (IGT), the Game of Dice Task and the Investment Task.
Results: Compared to PD patients without gambling behavior, those with PG obtained poorer scores in the IGT and in a rating scale of social behavior, but not in other decision-making and cognitive tasks.
Conclusions: Low performance in decision-making under ambiguity and abnormal social behavior distinguished PD patients with PG from those without this disorder. Dopamine replacement therapy may induce dysfunction of the ventromedial prefrontal cortex and amygdala-ventral striatum system, thus increasing the risk for developing PG.