Decision‑Making and Impulse‑Control Disorders in Parkinson’s Disease: Influence of Dopaminergic Treatment

Abstract

Objective: Dopaminergic treatment is proved to ameliorate motor deficits in Parkinson’s disease (PD); however, it could have negative effects on behavior and cognition, including impulse controlling and decision‑making. We aimed (1) to investigate the decision‑making and impulse‑control disorders (ICDs) of PD patients and their correlations with sociodemographical and clinical variables, dopaminergic treatment in particular, and (2) to determine the relation of decision‑making with ICDs. Methods: The sample of 39 patients with PD and 37 healthy controls underwent cognitive tests and the task which analyzeddecision‑making (Iowa Gambling Task [IGT]). Besides assessing motor andnonmotor symptoms of patients with PD, ICDs were also scanned using theQuestionnaire for Impulsive‑Compulsive Disorders in Parkinson’s Disease.Results: Although patients with PD performed similarly to healthy controls on IGT,decision‑making profile in PD related to clinical variables: dopaminergic treatmentand duration of illness. In addition to this younger age of onset, higher dose ofdopamine agonists, longer duration of illness, and impaired decision‑making weretogether accounted for a substantial amount of variance in impulsive behaviors.Conclusions: Dopaminergic medication likely contributes to the impairmentin decision‑making, which may be the underlying mechanism of ICDs. Furtherstudies will be necessary to understand the potential implications of this finding.