Al-Khaled Mohamed, Heldmann Marcus, Bolstorff Inga, Hagenah Johann, Münte Thomas F
Department of Neurology, University of Lübeck, Lübeck, Germany.
Department of Neurology, University of Lübeck, Lübeck, Germany; Institute of Psychology II, University of Lübeck, Lübeck, Germany.
Parkinsonism Relat Disord. 2015 Nov;21(11):1330-5. doi: 10.1016/j.parkreldis.2015.09.026. Epub 2015 Sep 25.
Impulse control disorders in Parkinson's disease are a potential consequence of dopaminergic therapy. Impulse control problems might be revealed by intertemporal choice tasks which entail to forgo an immediately available reward in favor of a larger but later reward. The steepness of the discounting curve can be quantified by the parameter k.
Participants (37 Parkinson patients [13 de novo, 24 medicated], 24 patients with restless legs syndrome, and 22 controls) were offered 54 choices between immediate smaller rewards and delayed larger and the k value was estimated from the participants' responses. Participants had the chance of winning one of their decisions. None of the participants had impulse control disorders.
Unmedicated Parkinson patients had a higher discounting rate than controls and medicated patients with restless legs syndrome. The k values of medicated Parkinson patients and patients with restless legs syndrome did not differ from those of controls. No correlation was found between the k value and the dopamine agonist dose.
Impulsive decision making in patients with Parkinson's disease may occur as part of the disease rather than as a consequence of dopamine agonist therapy.
帕金森病中的冲动控制障碍是多巴胺能治疗的潜在后果。冲动控制问题可能通过跨期选择任务揭示，该任务要求放弃即时可得的奖励以换取更大但更晚的奖励。贴现曲线的陡峭程度可用参数k来量化。
向参与者（37名帕金森病患者[13名初发患者，24名正在接受药物治疗的患者]、24名不宁腿综合征患者和22名对照者）提供54次在即时较小奖励与延迟较大奖励之间的选择，并根据参与者的反应估计k值。参与者有机会赢得他们所做决定中的一个。所有参与者均无冲动控制障碍。
未接受药物治疗的帕金森病患者的贴现率高于对照组以及接受药物治疗的不宁腿综合征患者。接受药物治疗的帕金森病患者和不宁腿综合征患者的k值与对照组无差异。未发现k值与多巴胺激动剂剂量之间存在相关性。
帕金森病患者的冲动决策可能是疾病的一部分，而非多巴胺激动剂治疗的结果。
