Department of Kinesiology, University of Connecticut, Storrs, CT, USA.
Departments of Occupational Therapy and Psychology & Brain Sciences, Boston University, Boston, MA, USA.
J Parkinsons Dis. 2021;11(2):725-735. doi: 10.3233/JPD-202353.
People with Parkinson's disease (PwPD) are less active than their age-matched peers. Non-motor symptoms, specifically, deficient motivation, may influence decision-making for exercise due to the impaired mesolimbic dopaminergic pathway.
The purpose of this study was to determine if effort-based decision-making for physical effort was different in PwPD compared to healthy controls. We sought to determine the relationship between effort-based decision making for exercise and a discrete motor task as well as the impact of components of motivation on decision-making for physical effort in PwPD.
An effort-based decision-making paradigm using a discrete motor task (button pressing) and a continuous exercise task (cycling) was implemented in 32 PwPD and 23 healthy controls. Components of motivation were measured using the Apathy Scale and the Temporal Experience of Pleasure Scale- Anticipatory Pleasure scale.
The presence of Parkinson's disease (PD) did not moderate decisions for either physical effort task. There was a moderate correlation between decisions for both tasks, within each group. The anticipation of pleasure and apathy were predictors of decisions for both physical effort tasks in PwPD, but not in healthy controls.
PwPD responded similarly to effort and reward valuations compared to those without PD. Individuals were consistent in their decisions, regardless of the physical effort task. The anticipation of pleasure and apathy were significant predictors of decisions for exercise in PwPD only. Increased anticipation of pleasure, reduction of apathy, and the use of rewards may enhance engagement in high effort exercise among PwPD.
帕金森病患者（PwPD）比同龄人更缺乏活力。非运动症状，特别是动机不足，可能会因中脑边缘多巴胺能通路受损而影响锻炼决策。
本研究旨在确定帕金森病患者与健康对照组相比，在体力活动的努力决策方面是否存在差异。我们旨在确定基于努力的运动决策与离散运动任务之间的关系，以及帕金森病患者中动机成分对体力努力决策的影响。
使用离散运动任务（按键）和连续运动任务（骑车）实施了基于努力的决策范式，纳入了 32 名帕金森病患者和 23 名健康对照组。使用淡漠量表和期待愉悦量表-预期愉悦量表测量了动机成分。
帕金森病的存在（PD）并没有调节两种体力活动任务的决策。在每个组中，两种任务的决策之间存在中度相关性。在帕金森病患者中，期待愉悦和淡漠是两种体力努力任务决策的预测因素，但在健康对照组中并非如此。
与没有 PD 的人相比，帕金森病患者对努力和奖励的评估反应相似。个体的决策是一致的，无论体力活动任务如何。只有在帕金森病患者中，期待愉悦和淡漠是锻炼决策的重要预测因素。增加期待愉悦、减少淡漠以及使用奖励可能会提高帕金森病患者进行高努力锻炼的参与度。
