Kobayakawa Mutsutaka, Tsuruya Natsuko, Kawamura Mitsuru
Department of Informatics, Tokyo University of Information Sciences, 4-1, Onaridai, Wakaba-ku, Chiba, Chiba 265-8501, Japan; Department of Neurology, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan.
Department of Psychological Informatics, College of Informatics and Human Communication, Kanazawa Institute of Technology, 7-1 Ohgigaoka, Nonoichi, Ishikawa 921-8501, Japan.
J Neurol Sci. 2017 Jan 15;372:232-238. doi: 10.1016/j.jns.2016.11.046. Epub 2016 Nov 24.
Patients with Parkinson's disease (PD) exhibit poor decision-making, and the underlying neural correlates are unclear. We used voxel-based morphometry with Diffeomorphic Anatomical Registration through Exponentiated Lie algebra to examine this issue.
The decision-making abilities of 20 patients with PD and 37 healthy controls (HCs) were measured with a computerized Iowa Gambling Task (IGT). We assessed the local gray matter volumes of the patients and HCs and their correlations with decision-making performance, disease duration, disease severity, and anti-Parkinsonism medication dose.
Compared with the HCs, the patients with PD exhibited poor IGT performances. The gray matter volumes in the medial orbitofrontal cortex, left inferior temporal cortex, and right middle frontal gyrus were decreased in the patients. Results in the regression analysis showed that lateral orbitofrontal volume correlated with performance in the IGT in PD. Regions that correlated with disease duration, severity, and medication dose did not overlap with orbitofrontal regions.
Our results indicate that the lateral and medial orbitofrontal cortex are related to decision-making in PD patients. Since the medial orbitofrontal cortex is shown to be involved in monitoring reward, reward monitoring seems to be impaired as a whole in PD patients. Meanwhile, the lateral region is related to evaluation of punishment, which is considered to have an influence on individual differences in decision-making performance in PD patients.
帕金森病（PD）患者存在决策能力缺陷，但其潜在的神经关联尚不清楚。我们使用基于体素的形态测量法和通过指数李代数进行的微分同胚解剖配准来研究这一问题。
采用计算机化爱荷华赌博任务（IGT）测量20例PD患者和37名健康对照者（HCs）的决策能力。我们评估了患者和HCs的局部灰质体积及其与决策表现、疾病持续时间、疾病严重程度和抗帕金森病药物剂量的相关性。
与HCs相比，PD患者的IGT表现较差。患者的内侧眶额皮质、左侧颞下回和右侧额中回的灰质体积减少。回归分析结果显示，外侧眶额体积与PD患者IGT的表现相关。与疾病持续时间、严重程度和药物剂量相关的区域与眶额区域不重叠。
我们的结果表明，外侧和内侧眶额皮质与PD患者的决策有关。由于内侧眶额皮质被证明参与奖励监测，PD患者的奖励监测似乎整体受损。同时，外侧区域与惩罚评估有关，这被认为对PD患者决策表现的个体差异有影响。
