Claassen Daniel O, van den Wildenberg Wery P M, Ridderinkhof K Richard, Jessup Charles K, Harrison Madaline B, Wooten G Frederick, Wylie Scott A
Department of Neurology.
Department of Psychology, University of Amsterdam.
Behav Neurosci. 2011 Aug;125(4):492-500. doi: 10.1037/a0023795.
Risk-taking behavior is characterized by pursuit of reward in spite of potential negative consequences. Dopamine neurotransmission along the mesocorticolimbic pathway is a potential modulator of risk behavior. In patients with Parkinson's disease (PD), impulse control disorder (ICD) can result from dopaminergic medication use, particularly dopamine agonists (DAA). Behaviors associated with ICD include hypersexuality as well as compulsive gambling, shopping, and eating, and these behaviors are potentially linked to alterations to risk processing. Using the Balloon Analogue Risk Task, we assessed the role of agonist therapy on risk-taking behavior in PD patients with (n = 22) and without (n = 19) active ICD symptoms. Patients performed the task both "on" and "off" DAA. DAA increased risk-taking in PD patients with active ICD symptoms, but it did not affect risk behavior of PD controls. DAA dose was also important in explaining risk behavior. Both groups similarly reduced their risk-taking in high compared to low risk conditions and following the occurrence of a negative consequence, suggesting that ICD patients do not necessarily differ in their abilities to process and adjust to some aspects of negative consequences. Our findings suggest dopaminergic augmentation of risk-taking behavior as a potential contributing mechanism for the emergence of ICD in PD patients.
冒险行为的特征是不顾潜在的负面后果而追求奖励。中脑皮质边缘通路的多巴胺神经传递是风险行为的一种潜在调节因素。在帕金森病（PD）患者中，冲动控制障碍（ICD）可能由使用多巴胺能药物引起，尤其是多巴胺激动剂（DAA）。与ICD相关的行为包括性欲亢进以及强迫性赌博、购物和饮食，这些行为可能与风险处理的改变有关。我们使用气球模拟风险任务，评估了激动剂治疗对有（n = 22）和无（n = 19）活跃ICD症状的PD患者冒险行为的作用。患者在服用和停用DAA的情况下都执行了该任务。DAA增加了有活跃ICD症状的PD患者的冒险行为，但对PD对照组的风险行为没有影响。DAA剂量在解释风险行为方面也很重要。与低风险条件相比，两组在高风险条件下以及出现负面后果后都同样降低了冒险行为，这表明ICD患者在处理和适应负面后果某些方面的能力不一定存在差异。我们的研究结果表明，多巴胺能增强冒险行为是PD患者出现ICD的一种潜在促成机制。
