Abstract

Impairments in decision making abilities including the assessment of options, balancing gain or loss and selection among the actions are observed in Parkinson’s disease (PD). Decision making which is experimentally studied under two paradigms including decision making under ambiguous conditions and at risk, neural network mainly comprising the frontostriatal and limbic loops including medial and orbitofrontal cortex, striatum, amygdala, basal ganglia, and anterior cingulate cortex, is considered to play a significant role. Despite several debates, it has been largely accepted that patients with PD tend to have disadvantageous decision making. Disease-specific neuropathological changes and dysfunctions in the limbic and frontostriatal pathways related to dopaminergic therapy are thought to be responsible for such a disadvantageous decision making strategy. Particularly, it has been claimed that dopamine has a deleterious effect on decision making, thereby leading to impulse control disorders. In this review, (i) decision making mechanisms and neuroanatomical structures related to this process were analyzed; (ii) the main findings obtained from PD studies were discussed and (iii) several recommendations on further studies in the future were proposed.