Cognitive and Neural Mechanisms of Impaired Social Decision-Making in Parkinsons Patients Taking Dopamine Agonists
Abstract
Medications that target dopamine are important treatments for the motor symptoms in patients with Parkinsons disease but can cause profound changes in behavior in some patients. For example, up to 46% of Parkinsons disease patients taking dopamine agonists develop impulsive and compulsive behaviors, including pathological gambling, hyper-sexuality, binge eating, and increased spending. In many instances, these behaviors can have social consequences, such as physical or emotional harm to family members and caregivers, and can even result in some patients breaking the law. However, little is known about how dopamine medications affect social decision-making in Parkinsons disease. Research in healthy subjects has shown that social decision-making involves a specific network of connected regions in the brain. Damage to this same brain network in other neurological patients can cause changes to social decision-making. Dopamine medications can change social decision-making in healthy subjects. Parkinsons patients can develop dysfunction in this brain network when taking dopamine agonists. However, it remains unclear whether this brain network dysfunction is related to changes in social decision-making in Parkinsons disease patients taking dopamine agonists. In Aim 1 of this study, we will test social decision-making in Parkinsons disease patients, predicting that dopamine agonists will causes changes to social decision-making in some patients with Parkinsons disease. In Aim 2, we will test whether changes in brain network function after taking dopamine agonists correspond to differences in social decision-making in Parkinsons patients. The CDMRP Parkinsons research program focus area for the new investigator award is mechanisms for cognitive and psychiatric symptoms in Parkinsons disease. Our proposal will determine the cognitive and neural mechanisms for how dopamine agonists lead to abnormal social decision-making in Parkinsons disease, directly addressing this topic. Social behavior problems can have an enormous impact on Parkinsons disease patients but are underappreciated and understudied. The results of our research will provide a better understanding of how dopamine medications can lead to these behaviors, how decision-making is affected, and what is happening in the brain to cause these symptoms. This will provide tools for clinicians to evaluate social behavior in Parkinsons patients, with the ultimate goal of identifying, preventing, and treating impaired social decision-making in Parkinsons disease patients in the future. My career goal is to become a clinician-scientist who uses cognitive testing and neuroimaging to better understand social decision-making in Parkinsons disease and related neurological disorders. The new investigator award will provide me with the opportunity to train in Parkinsons disease research in order to achieve this career goal. My primary research mentor, Dr. Daniel Claassen, is an experienced Parkinsons disease researcher who studies how dopamine leads to impulsive and compulsive behaviors in Parkinsons disease. My co-mentor, Dr. David Zald, is a professor of psychology and psychiatry who studies the relationship between dopamine, decision-making, and the brain. Both mentors will help me learn the research skills I need to continue to study cognitive and psychiatric symptoms in Parkinsons disease patients in the future. I will also take graduate-level classes and attend training courses to meet my career development goals.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910782
Entities
People
- Richard Darby
Organizations
- United States Army
- Vanderbilt University