RT Journal Article SR Electronic T1 Dopamine deficiency is associated with risk aversion but not loss aversion in Parkinson’s disease JF bioRxiv FD Cold Spring Harbor Laboratory SP 625467 DO 10.1101/625467 A1 Mariya V. Cherkasova A1 Jeffrey C. Corrow A1 Alisdair Taylor A1 Shanna C. Yeung A1 Jacob L. Stubbs A1 Martin J. McKeown A1 Silke Appel-Cresswell A1 A. Jon Stoessl A1 Jason J. S. Barton YR 2019 UL http://biorxiv.org/content/early/2019/05/05/625467.abstract AB Background Clinical evidence suggests that Parkinson’s Disease (PD) patients are risk-averse, but clear experimental evidence of this is surprisingly lacking. Anti-parkinsonian therapy has been reported to increase tolerance for risk, though findings have been mixed, and it has remained unclear whether this results from altered attitudes towards potential rewards, potential punishments or both. In some cases, alterations in reinforcement learning may have also been responsible for the findings.Objective To disambiguate the effects of PD and its therapy on attitudes towards rewards vs. losses in the context of risky decision making unconfounded by reinforcement learning.Method 36 patients with idiopathic PD receiving levodopa monotherapy and 36 healthy age-matched controls performed two behavioural economic tasks aimed at quantifying 1) risk tolerance/ aversion in the gain frame and 2) valuation of gains relative to losses. PD patients performed the tasks on and off their usual dose of levodopa in randomized order; the healthy controls performed the same tasks twice.Results Relative to the healthy controls, unmedicated PD patients showed significant risk aversion in the gain frame, which was normalized by levodopa. There was no difference between PD patients and controls in valuation of gains relative to losses. In addition, across both tasks and regardless of medication state, choices of the PD patients were more driven by expected values of the prospects than were the choices made by controls.Conclusion Dopamine deficiency in PD was associated with risk aversion but not with an altered valuation of gains relative to losses.Financial disclosure/conflict of interest: This work was supported by operating grant MOP-130566 from the Canadian Institutes of Health Research. JB was supported by Canada Research Chair 950-228984 and the Marianne Koerner Chair in Brain Diseases. AJS is supported by the Canada Research Chairs program. Authors declare no competing interests.