Correlati neurofisiologici del decision-making disfunzionale in pazienti con Malattia di Parkinson e Gambling Patologico

[Autom. eng. transl.] Among the main non-motor symptoms associated with Parkinson's Disease (Parkinson Disease, PD) include Impulse Control Disorders (ICD) such as, for example, Pathological Gambling, Compulsive Sexual Behavior, Syndrome from compulsive abuse of dopaminergic drug, compulsive shopping and hyperphagia. In recent years, interest in the study of subgroups of PD patients with PG has increased due to the seriousness of the personal, social and economic consequences that this disorder entails. Pathological Gambling can be defined as a dysfunctional and compulsive behavior linked to decision-making in high-risk situations. One of the classic tasks used to test the ability to distinguish between high and low risk decisions and evaluate their consequent situational learning effect is the Iowa Gambling Task (IGT). The present study aims to investigate from a neurophysiological and behavioral point of view the differences in decision-making processes between patients with PD without dementia who have active pathological gambling, compared both with PD patients who previously presented PG (now in remission) than with a control group composed of PD patients without PG. The sample included patients with PD (N = 42) between 50-70 years without dementia in stable dopaminergic treatment; the groups were divided into PD patients with PG (N = 14), former Pathological Gamblers (N = 10), and control patients with PD without ICD (N = 18). Electrophysiological activity was recorded by electroencephalography (EEG) during patient performance at the Iowa Gambling Task and was analyzed by analyzing cortical oscillations (frequency bands). Overall, the frequency band analysis showed a significant difference between the three groups. Specifically, an increase in the activity of low-frequency bands (mainly Delta and Theta) was detected within the posterior, temporo-occipital areas, in the group of PD patients with PG compared to the other two groups, mainly during disadvantageous decisions and risky (choices in which losses exceed winnings). While the Ex-Gamblers group of patients revealed a band power distribution similar to the patients belonging to the control group. This trend was also confirmed by the behavioral data, where the average of the disadvantageous choices by PD patients with PG is significantly higher than the other groups. In conclusion, the prevalent presence of low-frequency bands could underline an abnormal cortical response by patients with PG linked to their ability to monitor and control emotional behavior during a decision-making task where the reward mechanisms related to the dynamics of risk are particularly relevant.