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Behavioural Neurology
Volume 23, Issue 3, Pages 131-143

Decision Making under Risk Condition in Patients with Parkinson’s Disease: A Behavioural and fMRI Study

Kirsten Labudda,1,2 Matthias Brand,3,4 Markus Mertens,2 Isabelle Ollech,2 Hans J. Markowitsch,1,5 and Friedrich G. Woermann2

1Department of Physiological Psychology, University of Bielefeld, Germany
2MRI Unit, Mara Hospital, Bethel Epilepsy Center, Bielefeld, Germany
3General Psychology: Cognition, University of Duisburg-Essen, Germany
4Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
5Institute for Advanced Study, Alfried-Krupp Wissenschaftskolleg, Greifswald, Germany

Received 19 November 2010; Accepted 19 November 2010

Copyright © 2010 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We aimed to study whether previously described impairment in decision making under risky conditions in patients with Parkinson's disease (PD) is affected by deficits in using information about potential incentives or by processing feedback (in terms of fictitious gains and losses following each decision). Additionally, we studied whether the neural correlates of using explicit information in decision making under risk differ between PD patients and healthy subjects. We investigated ten cognitively intact PD patients and twelve healthy subjects with the Game of Dice Task (GDT) to assess risky decision making, and with an fMRI paradigm to analyse the neural correlates of information integration in the deliberative decision phase. Behaviourally, PD patients showed selective impairment in the GDT but not on the fMRI task that did not include a feedback component. Healthy subjects exhibited lateral prefrontal, anterior cingulate and parietal activations when integrating decision-relevant information. Despite similar behavioural patterns on the fMRI task, patients exhibited reduced parietal activation. Behavioural results suggest that PD patients’ deficits in risky decision making are dominated by impaired feedback utilization not compensable by intact cognitive functions. Our fMRI results suggest similarities but also differences in neural correlates when using explicit information for the decision process, potentially indicating different strategy application even if the interfering feedback component is excluded.