How Impulse Control Disorders Alter Processing of Risky Decisions

Summary: A novel study explores how Parkinson’s disease patients, particularly those with impulse control disorders (ICD) induced by dopaminergic medications, process the outcomes of risky decisions. The study, involving 30 participants, utilized a computer-based task to compare the decision-making behaviors of patients with and without ICD, revealing that those with ICD exhibit a diminished response to the consequences of their actions, a pattern that holds true regardless of medication status.

This research not only sheds light on the nuanced effects of Parkinson’s treatment on behavior but also suggests broader implications for understanding the psychological impacts of dopaminergic drugs and potentially addictive substances on decision-making and risk perception.

Key Facts:

  1. Dopaminergic Medications and ICD: Parkinson’s disease patients on these medications can develop impulse control disorders, leading to risky behaviors.
  2. Differential Processing of Risk: Patients with ICD exhibit altered processing of the outcomes of risky decisions, showing less responsiveness to negative outcomes.
  3. Medication’s Role in Risk Perception: The study suggests that the expectation of positive outcomes from risky decisions is heightened in medicated states, particularly in patients with ICD, pointing to a complex interplay between medication, disease, and risk behavior.

Source: Wake Forest University

Parkinson’s disease is a neurological disorder that affects movement and muscle control. One characteristic of the disease is the deficiency of dopamine, a neurotransmitter or brain chemical that plays a role in movement and can impact how people think and feel.

Dopaminergic medicines can help alleviate the symptoms of Parkinson’s disease. However, in some patients, the medications can cause impulse control disorder (ICD), characterized by risky behavior such as excessive gambling, shopping, sexual activity or eating.

This shows a woman holding her head.
When patients with ICD were on their medications, the researchers found that their expectations drove their feelings significantly more than when they were off of their medications. This difference was not observed for patients without ICD. Credit: Neuroscience News

In a new study, published online today in Scientific Reports, researchers found differences in how people with ICD process the consequences of their actions compared to those without ICD, both on and off medication.

“Our goal was to investigate how factors that influence the decision-making process may also affect how people feel in patients with and without ICD,” said Kenneth Kishida, Ph.D., corresponding author of the study and an associate professor of translational neuroscience and neurosurgery at Wake Forest University School of Medicine.

For the study, researchers recruited 30 people with Parkinson’s disease—18 individuals also had ICD and 12 individuals did not have ICD. All study participants performed a simple computer task in two different states—while on their dopaminergic medications and while off their dopaminergic medications.

The task presented repeated trials of risky choices (gambles) that consisted of a “sure bet” or a “gamble.” The “sure bet” was a guaranteed small amount of money, whereas the “gamble” was a 50-50 outcome of two different amounts of money. After the study participants made their choice, they were shown the outcome of their decision.

The participants were occasionally asked to rate how they felt about their outcome. The research team then used computational models to analyze the data.

“We found that participants with ICD showed a significant difference in the factors that drive their feelings about the risky decisions that they made,” Kishida said. “Compared to the non-ICD group, patients with ICD were not as affected by the consequences of their actions (good or bad). This was true regardless of their medication state.”

When patients with ICD were on their medications, the researchers found that their expectations drove their feelings significantly more than when they were off of their medications. This difference was not observed for patients without ICD.

“These results suggest that patients with ICD may get positive feelings from taking risky actions based on their expectations of good outcomes. But, when those risky choices do not pan out, they do not process the negative feedback in a typical way,” Kishida said.

“It may mean that these patients, when in a medicated state, may enjoy risky choices for the sake of risky choices, and they do not modulate their feelings in an appropriately negative way when the results are poor.”

Kishida said the findings might have implications for understanding the impact of dopaminergic drugs on behavior more generally and may provide clues about how addictive substances (such as nicotine, cocaine, or alcohol) may influence subjective feelings about risky behaviors or decision-making more generally.

“This study provides insight into the psychological and behavioral aspects of Parkinson’s disease, especially in the context of medication-induced side effects,” Kishida said. “It also contributes to a broader understanding of how dopaminergic drugs and addictive substances influence decision-making processes and subjective feelings related to risky behaviors.”

About this impulse control disorder and neuroscience research news

Author: Myra Wright
Source: Wake Forest University
Contact: Myra Wright – Wake Forest University
Image: The image is credited to Neuroscience News

Original Research: The findings will appear in Scientific Reports

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