Kobayakawa Mutsutaka, Koyama Shinichi, Mimura Masaru, Kawamura Mitsuru
Department of Neurology, Showa University School of Medicine, Tokyo, Japan.
Mov Disord. 2008 Mar 15;23(4):547-52. doi: 10.1002/mds.21865.
Recent studies suggest that social recognition processes are affected by Parkinson's disease (PD). However, whether PD patients exhibit behavioral changes is still controversial. The purpose of the present study was to examine the decision making of PD patients performing the Iowa Gambling Task (IGT). We recruited a large number of early, nondemented PD patients for the IGT. We also recorded the skin conductance responses (SCRs) during the task as a measure of emotional arousal. Compared with the normal control (NC) subjects, PD patients selected more disadvantageous decks in the IGT, and their SCRs were lower than those of NC subjects before making decisions and after receiving reward or punishment. The tendency toward risky choices was not correlated with age, education, global cognitive function, or the severity of the disease. These results confirmed that the decision making of PD patients was affected by the disease, rather than by other cognitive functions; moreover, such behavior was related to lower emotional responses. Behavioral and SCR patterns of PD patients were similar to those of amygdala-damaged patients. The response bias toward risky choices in PD may be explained by the dysfunction of the amygdala, which is known to be involved in risk evaluation.
最近的研究表明，社会认知过程会受到帕金森病（PD）的影响。然而，PD患者是否表现出行为变化仍存在争议。本研究的目的是考察执行爱荷华赌博任务（IGT）的PD患者的决策情况。我们招募了大量早期、无痴呆的PD患者来进行IGT。我们还记录了任务期间的皮肤电反应（SCR），作为情绪唤醒的一种测量指标。与正常对照（NC）组受试者相比，PD患者在IGT中选择了更多不利的牌组，并且他们在做出决策前以及在接受奖励或惩罚后的SCR低于NC组受试者。冒险选择的倾向与年龄、教育程度、整体认知功能或疾病严重程度无关。这些结果证实，PD患者的决策受到疾病的影响，而非其他认知功能的影响；此外，这种行为与较低的情绪反应有关。PD患者的行为和SCR模式与杏仁核受损患者的相似。PD患者对冒险选择的反应偏差可能由杏仁核功能障碍来解释，已知杏仁核参与风险评估。
