Ponsi Giorgia, Scattolin Marina, Villa Riccardo, Aglioti Salvatore Maria
Department of Psychology Sapienza University of Rome and CLNS@SAPIENZA Roma, Istituto Italiano di Tecnologia, Genova, Italy.
IRCCS Fondazione Santa Lucia, Roma, Italy.
NPJ Parkinsons Dis. 2021 Mar 2;7(1):18. doi: 10.1038/s41531-021-00167-w.
Parkinson's disease (PD) is a neurodegenerative disorder characterized by the loss of dopaminergic neurons in the basal ganglia (BG) and thalamocortical circuitry. While defective motor control has long been considered the defining symptom of PD, mounting evidence indicates that the BG are fundamentally important for a multitude of cognitive, emotional, and motivational processes in addition to motor function. Here, we review alterations in moral decision-making in people with PD, specifically in the context of deceptive behavior. We report that PD patients exhibit two opposite behavioral patterns: hyper- and hypo-honesty. The hyper-honest subgroup engages in deception less often than matched controls, even when lying is associated with a monetary payoff. This behavioral pattern seems to be linked to dopaminergic hypo-activity, implying enhanced harm avoidance, risk aversion, non-impulsivity, and reduced reward sensitivity. On the contrary, the hypo-honest subgroup-often characterized by the additional diagnosis of impulse control disorders (ICDs) and dopamine dysregulation syndrome (DDS)-deceives more often than both PD patients without ICDs/DDS and controls. This behavioral pattern appears to be associated with dopaminergic hyperactivity, which underpins enhanced novelty-seeking, risk-proneness, impulsivity, and reward sensitivity. We posit that these two complementary behavioral patterns might be related to dysfunction of the dopaminergic reward system, leading to reduced or enhanced motivation to deceive. Only a few studies have directly investigated moral decision-making in PD and other neurodegenerative disorders affecting the BG, and further research on the causal role of subcortical structures in shaping moral behavior is needed.
帕金森病（PD）是一种神经退行性疾病，其特征是基底神经节（BG）和丘脑皮质回路中的多巴胺能神经元丧失。长期以来，运动控制缺陷一直被认为是PD的决定性症状，但越来越多的证据表明，除了运动功能外，BG对多种认知、情感和动机过程也至关重要。在这里，我们回顾了PD患者道德决策的改变，特别是在欺骗行为的背景下。我们报告称，PD患者表现出两种相反的行为模式：过度诚实和诚实不足。过度诚实的亚组比匹配的对照组更少参与欺骗，即使说谎与金钱回报相关。这种行为模式似乎与多巴胺能低活性有关，这意味着增强了对伤害的回避、风险厌恶、非冲动性和降低了奖励敏感性。相反，诚实不足的亚组——通常以额外诊断为冲动控制障碍（ICD）和多巴胺调节障碍综合征（DDS）为特征——比没有ICD/DDS的PD患者和对照组更频繁地欺骗。这种行为模式似乎与多巴胺能亢进有关，这支持了增强的寻求新奇、风险倾向、冲动性和奖励敏感性。我们认为，这两种互补的行为模式可能与多巴胺能奖励系统的功能障碍有关，导致欺骗动机降低或增强。只有少数研究直接调查了PD和其他影响BG的神经退行性疾病中的道德决策，需要进一步研究皮层下结构在塑造道德行为中的因果作用。
