Perseveration and choice in Parkinson’s disease: the impact of progressive frontostriatal dysfunction on action decisions.
Cerebral Cortex. 2012-06-01; 23(7): 1572-1581
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1. Cereb Cortex. 2013 Jul;23(7):1572-81. doi: 10.1093/cercor/bhs144. Epub 2012 Jun
Perseveration and choice in Parkinson’s disease: the impact of progressive
frontostriatal dysfunction on action decisions.
Hughes LE(1), Altena E, Barker RA, Rowe JB.
(1)Medical Research Council Cognition and Brain Sciences Unit, Cambridge CB2 7EF,
We have previously shown that patients with Parkinson’s disease (PD) perseverate
in their choice of action relative to healthy controls, and that this is affected
by dopaminergic medication (Hughes LE, Barker RA, Owen AM, Rowe JB. 2010.
Parkinson’s disease and healthy aging: Independent and interacting effects on
action selection. Hum Brain Mapp. 31:1886-1899). To understand further the neural
basis of these phenomena, we used a new task that manipulated the options to
repeat responses. Seventeen patients with idiopathic PD were studied both “on”
and “off” dopaminergic medication and 18 healthy adults were scanned twice as
controls. All subjects performed a right-handed 3-choice button press task, which
controlled the availability of repeatable responses. The frequency of choosing to
repeat a response (a form of perseveration) in patients was related to dopamine
therapy and disease severity as a “U-shaped” function. For repetitive trials,
this “U-shaped” relationship was also reflected in the BOLD response in the
caudate nuclei and ventrolateral prefrontal cortex. Our results support a
U-shaped model of optimized cortico-striatal circuit function and clearly
demonstrate that flexibility in response choice is modulated by an interaction of
dopamine and disease severity.
PMID: 22661404 [Indexed for MEDLINE]