Acting without being in control: Exploring volition in Parkinson's disease with impulsive compulsive behaviours

作者：Ricciardi Lucia^*; Haggard Patrick; de Boer Lieke; Sorbera Chiara; Stenner Max Philipp; Morgante Francesca; Edwards Mark J

来源：Parkinsonism & Related Disorders, 2017, 40: 51-57.

DOI：10.1016/j.parkreldis.2017.04.011

• Parkinson's disease
• Impulse control disorders
• Impulsive-compulsive behaviours
• Sense of agency
• Action inhibition
• Reward

Background: Several aspects of volitional control of action may be relevant in the pathophysiology of impulsive-compulsive behaviours (ICB) in Parkinson's disease (PD). We aimed to explore multiple aspects of action control, assessing reward-related behaviour, inhibition (externally and internally triggered) and sense of agency in PD patients, with and without ICB compared to healthy subjects.
Methods: Nineteen PD patients with ICB (PD-ICB), 19 PD without ICB (PD-no-ICB) and 19 healthy controls (HC) underwent a battery of tests including: Intentional Binding task which measures sense of agency; Stop Signal Reaction Time (SSRT) measuring capacity for reactive inhibition; the Marble task, assessing intentional inhibition; Balloon Analog Risk Task for reward sensitivity.
Results: One-way ANOVA showed significant main effect of group for action binding (p = 0.004, F = 6.27). Post hoc analysis revealed that PD-ICB had significantly stronger action binding than HC (p = 0.004), and PD-no-ICB (p = 0.04). There was no difference between PD-no-ICB and HC. SSRT did not differ between PD groups, whereas a significant difference between PD-no-ICB and HC was detected (p = 0.01). No other differences were found among groups in the other tasks.
Conclusions: PD patients with ICB have abnormal performance on a psychophysical task assessing sense of agency, which might be related to a deficit in action representation at cognitive/experiential level. Yet, they have no deficit on tasks evaluating externally and internally triggered inhibitory control, or in reward-based decision-making. We conclude that impaired sense of agency may be a factor contributing to ICB in PD patients.

• 出版日期2017-7