Abstract
Introduction The aim of this study was to investigate the functional anatomy of decision-making during the Iowa Gambling Task in patients with Parkinson’s disease (PD). Method We used event-related functional magnetic resonance imaging (fMRI) during a computerized version of IGT to compare 18 PD patients on dopaminergic medication in the ON state and 18 healthy control subjects. Our analyses focused on outcome evaluation following card selection, because we expected this aspect of decision making to be impaired in PD patients. Results The PD patients exhibited lower activation of the left putamen than the control group as a reaction to penalty. Using psychophysiological interaction analysis, we identified decreased functional connectivity between the right globus pallidus internus and the left anterior cingulate gyrus in the PD group. In contrast, increased connectivity between these structures was observed after penalty in the control group. Conclusions Our results suggest altered functioning of the basal ganglia and their connections with the cortical structures involved in the limbic loop (e.g. the limbic fronto-striatal circuit of the basal ganglia) during decision making in PD patients. Differences in the response to loss could be associated with insufficient negative reinforcement following a loss in PD patients in the ON state in comparison to a healthy population. This work was supported by the project “CEITEC - Central European Institute of Technology” (CZ.1.05/1.1.00/02.0068) from the European Regional Development Fund. The participation of T.U. was supported by a research project of the Czech Science Foundation, No. P407/12/2432. The participation of J.V. was supported by the European Regional Development Fund Project FNUSA-ICRC (No. CZ.1.05/1.1.00/02.0123).
Published Version
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