Modulation Of Feedback-Related Negativity During Trial-And-Error Task In Parkinson'S Disease: Assessing The Role Of Apathy And Depression In Cognitive Impairments

JOURNAL OF THE NEUROLOGICAL SCIENCES(2015)

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Abstract
Parkinson’s disease (PD) is accompanied by a variety of neuropsychiatric symptoms, like apathy and depression, and cognitive deficits. The feedback-related negativity (fERN) is a mid-frontal event-related potential recorded in various cognitive tasks and has been proposed to reflect neural response to prediction errors during reinforcement learning. There are still some aspects of apathy and depression that remain unknown. Notably, whether they are associated independently with cognitive deficits, and how is modulated the fERN within apathetic and depressive groups. Especially its sensitivity to positive and negative reward prediction error. 55 PD patients were recruited from the Department of Neurology at Carlos Van Buren Hospital of Valparaiso and completed a comprehensive clinical and neuropsychological evaluation. We recorded EEG activity during a problem solving task (PST) where each subject had to search by trial and error which of four visual targets was associated with a correct feedback. Apathy was diagnosed in 24/55 participants (43%). In 39.9% of patients apathy coexisted with depression, whereas only 12.7% were apathetic without depression. Apathy was significantly associated with higher depression scores, lower cognitive functioning, more severe motor symptoms, longer reaction times and errors in the PST, and decreased fERN. Our results suggest that apathy but not depression is associated with impaired cognition in PD. Analyses showed that the fERN was modulated by both negative and positive prediction error. From a clinical point of view the clearly attenuated fERN in apathetic PD patients may prove a useful additional tool for the early diagnosis of dopamine dysfunction in PD.
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Key words
parkinsons disease,apathy,depression,feedback-related,trial-and-error
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