Department of Psychology and Behavioural Sciences, Aarhus University , Aarhus, Denmark.
Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University , Aarhus, Denmark.
J Clin Exp Neuropsychol. 2020 Jul;42(5):425-435. doi: 10.1080/13803395.2020.1749237. Epub 2020 Apr 14.
Decision-making impairments in Parkinson's disease (PD) have frequently been measured using the Iowa Gambling Task (IGT), though results have been inconsistent. At present, task performance has primarily been evaluated based on the total IGT score, and there is a need for further analysis of the strategy of older individuals with PD and healthy control (HC) participants in IGT.
The present study aims to explore possible impairments in IGT performance in individuals with PD compared to healthy controls using strategy analysis, extending previous results on this subject, and to discuss potential effects of medication on task performance.
67 individuals with PD and 29 HC participants completed the IGT. Results were analyzed to evaluate impairments, applied strategies, presence of subgroups, and potential effects of medication on performance.
Both groups obtained a low overall IGT score and individuals with PD had significantly lower total IGT scores compared to HC participants. Regression analysis showed a small, but significant relationship between levodopa and dopamine agonist dosage and total IGT score, indicating that medication level could be a marker of level of executive functions. Subgroups of advantageous and disadvantageous choosers differed significantly in deck preferences for both groups.
Individuals with PD were significantly impaired in IGT performance, both in overall scores and in detailed analyses, and they utilized an inefficient strategy during task performance. However, HC participants also presented with a suboptimal strategy and results suggest the presence of subgroups in both individuals with PD and HC participants, which may reflect age-related changes. These results are in line with previous research on performance of older individuals and alternative deck preferences in the IGT and underline the importance of considering the applied strategy in the evaluation of IGT performance.
帕金森病（PD）患者的决策障碍经常通过赌博任务（IGT）进行测量，但结果并不一致。目前，主要基于总的 IGT 分数评估任务表现，需要进一步分析 PD 患者和健康对照（HC）参与者在 IGT 中的策略。
本研究旨在使用策略分析探讨 PD 患者与健康对照者在 IGT 中的表现可能存在的损害，扩展该主题的先前结果，并讨论药物对任务表现的潜在影响。
67 名 PD 患者和 29 名 HC 参与者完成了 IGT。分析结果以评估损害、应用的策略、亚组的存在以及药物对表现的潜在影响。
两组的总 IGT 得分均较低，PD 患者的总 IGT 得分明显低于 HC 参与者。回归分析显示，左旋多巴和多巴胺激动剂剂量与总 IGT 得分之间存在小但显著的关系，表明药物水平可能是执行功能水平的标志物。两组的优势和劣势选择者在两组的牌组偏好上存在显著差异。
PD 患者在 IGT 表现中明显受损，无论是在总体得分还是在详细分析中，并且他们在任务表现中使用了低效的策略。然而，HC 参与者也表现出了次优的策略，结果表明 PD 患者和 HC 参与者中存在亚组，这可能反映了与年龄相关的变化。这些结果与先前关于老年个体和 IGT 中替代牌组偏好的表现的研究一致，并强调了在评估 IGT 表现时考虑应用策略的重要性。
