JNNP: Disruption in reward processing in Parkinson's disease and its association with dopamine status and neuropsychiatric syndromes - a systematic review and meta-analysis

Parkinson's disease (PD) is the fastest growing neurological disease worldwide, with an estimated annual social cost comparable to that of dementia
.

Traditionally conceptualized as movement disorders, non-motor symptoms, including disruptions in mood, cognition, and motivation, are common and have a greater negative impact on health-related quality of life

Quality of life Impaired reward processing is a prominent cross- diagnostic feature of several mental health disorders, such as depression , and represents a useful framework for understanding motivation-related symptoms .
The National Institute of Mental Health's Research Area Standards identify reward processing as one of six major areas underpinning human functioning and psychopathology .
Dopamine has a well-established role in reward and motivational pathways .
Impaired reward processing is a prominent transdiagnostic feature of several mental health disorders, such as depression , and represents a useful framework for understanding motivation-related symptoms .
The National Institute of Mental Health's Research Area Standards identify reward processing as one of six major areas underpinning human functioning and psychopathology .
Dopamine has a well-established role in reward and motivational pathways .
diagnosis

PD is caused by dopaminergic cell death and is therefore a model of striatal and dopamine dysfunction
.

The striatum interconnects with the prefrontal region and other parts of the basal ganglia and midbrain, forming frontostriatal circuits involved in the initiation and control of motor, cognitive and emotional functions

Over the past two decades, research on reward processing in PD has typically used behavioral tasks to evaluate three subprocesses8: (1) option evaluation, when explicit information about those options is given (e.
g.

This article was published in the Journal of Neurology, Neurosurgery & Psychiatry .

Ovid MEDLINE/PubMed, Embase and PsycInfo databases were searched for articles published between January 1, 1946 and November 5, 2020 (inclusive), whose titles or abstracts contained the following terms: Parkins* and (reward* or motivation) *or motivating* or effort* or deci*) and (psychotic or neuropsychiatric or depression* or psychotic or delusional* or impulsivity* or mood or anxiety or apathy or anhedonia or hallucinations*)
.

Inclusion criteria were as follows: (1) a case-control design; (2) included a PD group without dementia or deep brain stimulation (DBS) (studies including participants in the PD group with dementia or DBS were excluded); (3) The participant is at least 18 years of age; (4) The participant performed a reward processing task; (5) The task reward was clear, i.

Research Process

Fifty-five studies with 2578 participants (1638 PD and 940 healthy controls) were identified
.

Includes studies evaluating three subcomponent categories of the reward processing task: option evaluation (n=12), reinforcement learning (n=37), and reward-response vitality (n=6)

However, the opposite holds true for reinforcement learning, relative to healthy controls, impaired on medication (SMD=0.

Forest Plot for Reward Processing (RP)

This article is the first systematic review and meta-analysis of reward processing in PD, related neuropsychiatric syndromes, and the effects of dopaminergic drugs
.

Across all 55 studies, including different subcomponents of reward processing, PD patients were found to have small-to-medium reward processing impairments relative to healthy participant populations

The extent of impairment of reward processing is similar to that reported in major depressive disorder, in which dysfunctional reward processing is a major etiological candidate mechanism for 'activity of interest' symptoms such as anhedonia

CostelloH ,BerryAJ ,ReevesS CostelloHCostello BerryAJBerry ReevesSReeves, et alDisrupted reward processing in Parkinson's disease and its relationship with dopamine state and neuropsychiatric syndromes: a systematic review and meta-analysisJournal of Neurology, Neurosurgery & PsychiatryPublished Online First:20 December 2021.

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