Bódi Nikoletta, Kéri Szabolcs, Nagy Helga, Moustafa Ahmed, Myers Catherine E, Daw Nathaniel, Dibó György, Takáts Annamária, Bereczki Dániel, Gluck Mark A
Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
Brain. 2009 Sep;132(Pt 9):2385-95. doi: 10.1093/brain/awp094. Epub 2009 May 4.
Parkinson's disease is characterized by the degeneration of dopaminergic pathways projecting to the striatum. These pathways are implicated in reward prediction. In this study, we investigated reward and punishment processing in young, never-medicated Parkinson's disease patients, recently medicated patients receiving the dopamine receptor agonists pramipexole and ropinirole and healthy controls. The never-medicated patients were also re-evaluated after 12 weeks of treatment with dopamine agonists. Reward and punishment processing was assessed by a feedback-based probabilistic classification task. Personality characteristics were measured by the temperament and character inventory. Results revealed that never-medicated patients with Parkinson's disease showed selective deficits on reward processing and novelty seeking, which were remediated by dopamine agonists. These medications disrupted punishment processing. In addition, dopamine agonists increased the correlation between reward processing and novelty seeking, whereas these drugs decreased the correlation between punishment processing and harm avoidance. Our finding that dopamine agonist administration in young patients with Parkinson's disease resulted in increased novelty seeking, enhanced reward processing, and decreased punishment processing may shed light on the cognitive and personality bases of the impulse control disorders, which arise as side-effects of dopamine agonist therapy in some Parkinson's disease patients.
帕金森病的特征是投射到纹状体的多巴胺能通路发生退化。这些通路与奖励预测有关。在本研究中,我们调查了年轻的、未接受过药物治疗的帕金森病患者、近期接受多巴胺受体激动剂普拉克索和罗匹尼罗治疗的药物治疗患者以及健康对照者的奖励和惩罚处理情况。未接受过药物治疗的患者在接受多巴胺激动剂治疗12周后也进行了重新评估。通过基于反馈的概率分类任务评估奖励和惩罚处理情况。通过气质和性格量表测量人格特征。结果显示,未接受过药物治疗的帕金森病患者在奖励处理和寻求新奇方面表现出选择性缺陷,多巴胺激动剂可纠正这些缺陷。这些药物干扰了惩罚处理。此外,多巴胺激动剂增加了奖励处理与寻求新奇之间的相关性,而这些药物降低了惩罚处理与避免伤害之间的相关性。我们的研究发现,在年轻的帕金森病患者中给予多巴胺激动剂会导致寻求新奇增加、奖励处理增强和惩罚处理减少,这可能有助于揭示冲动控制障碍的认知和人格基础,冲动控制障碍是多巴胺激动剂治疗在一些帕金森病患者中产生的副作用。