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Clinical Manifestations.

Lee-Anne Morris1, Hideo Suzuki2, Seonjoo Lee3

  • 1University of Otago, Christchurch, Canterbury, New Zealand.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Effort-based decision-making is disrupted in Alzheimer's and Parkinson's disease, impacting motivation. Cognitive processes like information processing and response execution are affected, offering insights into neurodegeneration.

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Neurology

Background:

  • Loss of motivation is a key symptom in Alzheimer's disease (AD) and Parkinson's disease (PD).
  • Effort-based decision-making, crucial for goal-directed behavior, involves balancing rewards against effort costs.
  • Understanding disruptions in this process is vital for addressing motivational deficits in neurodegenerative conditions.

Purpose of the Study:

  • To investigate the latent cognitive processes underlying effort-based decision-making in individuals with varying motivation levels and diagnoses.
  • To determine if disruptions in decision-making parameters are consistent across different neurodegenerative disorders.

Main Methods:

  • Participants with AD (n=37), PD (n=52), and healthy controls (n=21) completed the Apple Gathering Task.
  • Drift diffusion modeling analyzed choices and reaction times to reveal cognitive processes.
  • Linear regression models examined associations between apathy, diagnosis, and cognitive parameters, controlling for age and cognition.

Main Results:

  • Lower motivation correlated with reduced reward acceptance, slower information processing (drift rate), higher decision thresholds, and increased rejection bias.
  • Individuals with AD showed reduced sensitivity to effort variations and higher decision thresholds compared to PD and controls.
  • Decision-making parameters like non-decision time were also linked to motivational deficits.

Conclusions:

  • Motivational loss in AD and PD is linked to impaired effort-based decision-making, affecting information processing, response execution, and decision bias.
  • Alzheimer's disease is further characterized by increased decision noise and difficulty integrating effort information.
  • Decision-making tasks offer a valuable tool for studying cognitive mechanisms of motivational deficits in neurodegeneration.