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Reward learning deficits in Parkinson's disease depend on depression
M H M Timmer1, G Sescousse1, M E van der Schaaf1
1Donders Institute for Brain,Cognition and Behaviour,Centre for Cognitive Neuroimaging,Radboud University,Nijmegen,The Netherlands.
Background:
Depression is one of the most common and debilitating non-motor symptoms of Parkinson's disease (PD). The neurocognitive mechanisms underlying depression in PD are unclear and treatment is often suboptimal.
Methods:
We investigated the role of striatal dopamine in reversal learning from reward and punishment by combining a controlled medication withdrawal procedure with functional magnetic resonance imaging in 22 non-depressed PD patients and 19 PD patients with past or present depression.
Results:
PD patients with a depression (history) exhibited impaired reward v. punishment reversal learning as well as reduced reward v. punishment-related BOLD signal in the striatum (putamen) compared with non-depressed PD patients. No effects of dopaminergic medication were observed.
Conclusions:
The present findings demonstrate that impairments in reversal learning from reward v. punishment and associated striatal signalling depend on the presence of (a history of) depression in PD.