Brain Advance Access originally published online on March 15, 2008
Brain 2008 131(5):1303-1310; doi:10.1093/brain/awn045
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Disconnecting force from money: effects of basal ganglia damage on incentive motivation
1Laboratoire INSERM U610, Institut Fédératif de Recherches en Neurosciences, Université Pierre et Marie Curie (Paris 6), Site Pitié-Salpêtrière, F-75013 Paris, 2Laboratoire URECA, Université Charles de Gaulle (Lille 3), F-59659 Villeneuve d’Ascq and 3Centre d’investigation clinique, Fédération des Maladies du système nerveux, Assistance Publique – Hôpitaux de Paris, Groupe Pitié-Salpêtrière, F-75013 Paris, France
Correspondence to: Mathias Pessiglione, Laboratoire INSERM U610, Hôpital Pitié-Salpêtrière, 47 Boulevard de l'Hôpital, 75013, Paris, France E-mail: pessigli{at}ccr.jussieu.fr
Bilateral basal ganglia lesions have been reported to induce a particular form of apathy, termed auto-activation deficit (AAD), principally defined as a loss of self-driven behaviour that is reversible with external stimulation. We hypothesized that AAD reflects a dysfunction of incentive motivation, a process that translates an expected reward (or goal) into behavioural activation. To investigate this hypothesis, we designed a behavioural paradigm contrasting an instructed (externally driven) task, in which subjects have to produce different levels of force by squeezing a hand grip, to an incentive (self-driven) task, in which subjects can win, depending on their hand grip force, different amounts of money. Skin conductance was simultaneously measured to index affective evaluation of monetary incentives. Thirteen AAD patients with bilateral striato-pallidal lesions were compared to thirteen unmedicated patients with Parkinson's; disease (PD), which is characterized by striatal dopamine depletion and regularly associated with apathy. AAD patients did not differ from PD patients in terms of grip force response to external instructions or skin conductance response to monetary incentives. However, unlike PD patients, they failed to distinguish between monetary incentives in their grip force. We conclude that bilateral striato-pallidal damage specifically disconnects motor output from affective evaluation of potential rewards.
Key Words: apathy; anoxic/ischaemic damage; Parkinson's disease; reward; effort
Abbreviations: AAD, auto-activation deficit; GFR, grip force response; MADRS, Montgomery and Asberg depression rating scale; MMSE, mini mental state examination; MRI, magnetic resonance imaging; MVC, maximal voluntary contraction; PD, Parkinson's disease; SCR, skin conductance response; UPDRS III, unified Parkinson's disease rating scale III
Received November 15, 2007. Revised February 14, 2008. Accepted February 20, 2008.
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