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Eur J Neurol. 2010 Jan;17(1):97-102. doi: 10.1111/j.1468-1331.2009.02792.x. Epub 2009 Sep 23.

Decision-making in Parkinson's disease patients with and without pathological gambling.

Author information

  • 1Movement Disorders Section, Raul Carrea Institute for Neurological Research, FLENI, Buenos Aires, Argentina.

Erratum in

  • Eur J Neurol. 2011 May;18(5):797. Gerschcovich, E R [corrected to Gerschcovich, E Roldan].

Abstract

BACKGROUND AND PURPOSE:

Pathological gambling (PG) in Parkinson's disease (PD) is a frequent impulse control disorder associated mainly with dopamine replacement therapy. As impairments in decision-making were described independently in PG and PD, the objective of this study was to assess decision-making processes in PD patients with and without PG.

METHODS:

Seven PD patients with PG and 13 age, sex, education and disease severity matched PD patients without gambling behavior were enrolled in the study. All patients were assessed with a comprehensive neuropsychiatric and cognitive evaluation, including tasks used to assess decision-making abilities under ambiguous or risky situations, like the Iowa Gambling Task (IGT), the Game of Dice Task and the Investment Task.

RESULTS:

Compared to PD patients without gambling behavior, those with PG obtained poorer scores in the IGT and in a rating scale of social behavior, but not in other decision-making and cognitive tasks.

CONCLUSIONS:

Low performance in decision-making under ambiguity and abnormal social behavior distinguished PD patients with PG from those without this disorder. Dopamine replacement therapy may induce dysfunction of the ventromedial prefrontal cortex and amygdala-ventral striatum system, thus increasing the risk for developing PG.

PMID:
19780806
[PubMed - indexed for MEDLINE]
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