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01-09-2018 | Review

The moral brain and moral behaviour in patients with Parkinson’s disease: a review of the literature

Authors: Patrick Santens, Giel Vanschoenbeek, Marijke Miatton, Miet De Letter

Published in: Acta Neurologica Belgica | Issue 3/2018

Abstract

Morality is a complex and versatile concept that necessitates the integrated activity of multiple interacting networks in the brain. Numerous cortical and subcortical areas, many of which are implicated in either emotional and cognitive control or Theory of Mind, are involved in the processing of moral behaviour. Different methods have been used to investigate various aspects of morality, which has lead to confusing and sometimes opposing results. Emotional, cognitive and personality changes have long been recognized in Parkinson’s disease (PD) patients, suggesting a potential impact on moral aspects of behaviour in daily living situations. Alterations in social cognition have been described in all stages of PD but these are rather directly related to PD pathology and not to dopaminergic or DBS treatment. There are no convincing data supporting the hypothesis that dopaminergic treatment or deep brain stimulation of the STN per se interfere with morality in PD patients, although subgroups of patients may display socially unacceptable behaviour. Research in social cognition in PD patients is a fascinating topic that needs further attention in view of the impact on quality of life for PD patients and their caregivers.

Gert B, Gert J, Zalta EN (2016) The definition of morality. The Stanford encyclopedia of philosophy 2016. https://plato.stanford.edu/archives/spr2016/entries/morality-definition. Accessed 16 Nov 2016

Bradford EE, Jentzsch I, Gomez JC (2015) From self to social cognition: theory of mind mechanisms and their relation to executive functioning. Cognition 138:21–34. https://doi.org/10.1016/j.cognition.2015.02.001 CrossRefPubMed

Knobe J (2005) Theory of mind and moral cognition: exploring the connections. Trends Cogn Sci 9:357–359 (Review).CrossRefPubMed

Knyazev GG, Savostyanov AN, Bocharov AV, Merkulova EA (2018) Resting state connectivity mediates the relationship between collectivism and social cognition. Int J Psychophysiol 123: 17–24. https://doi.org/10.1016/j.ijpsycho.2017.12.002 CrossRefPubMed

Garrigan B, Adlam ALR, Langdon PE (2016) The neural correlates of moral decision-making: a systematic review and meta-analysis of moral evaluations and response decision judgments. Brain Cognit 108:88–97. https://doi.org/10.1016/j.bandc.2016.07.007 CrossRef

Boccia M, Dacquino C, Piccardi L et al (2016) Neural foundation of human moral reasoning: an ALE meta-analysis about the role of personal perspective. Brain Imaging Behav 11:278–292. https://doi.org/10.1007/s11682-016-9505-x CrossRef

Parkinson C, Sinnott-Armstrong W, Koralus PE et al (2011) Is morality unified? Evidence that distinct neural systems underlie moral judgments of harm, dishonesty, and disgust. J Cogn Neurosci 23:3162–3180. https://doi.org/10.1162/jocn_a_00017 CrossRefPubMed

Fumagalli M, Priori A (2012) Functional and clinical neuroanatomy of morality. Brain 135:2006–2021. https://doi.org/10.1093/brain/awr334 CrossRefPubMed

Koenigs M, Young L, Adolphs R et al (2007) Damage to the prefrontal cortex increases utilitarian moral judgments. Nature 446:908–911. https://doi.org/10.1038/nature05631 CrossRefPubMedPubMedCentral

10.

Young L, Koenigs M (2007) Investigating emotion in moral cognition: a review of evidence from functional neuroimaging and neuropsychology. Br Med Bull 84:69–79. https://doi.org/10.1093/bmb/ldm031 CrossRefPubMed

11.

Tassy S, Oullier O, Mancini J, Wicker B (2013) Discrepancies between judgment and choice of action in moral dilemmas. Front Psychol 4:250. https://doi.org/10.3389/fpsyg.2013.00250 CrossRefPubMedPubMedCentral

12.

Couto B, Sedeño L, Sposato LA, Sigman M, Riccio PM, Salles A, Lopez V, Schroeder J, Manes F, Ibanez A (2013) Insular networks for emotional processing and social cognition: comparison of two case reports with either cortical or subcortical involvement. Cortex 49:1420–1434. https://doi.org/10.1016/j.cortex.2012.08.006 CrossRefPubMed

13.

Iwry J, Yaden D, Newberg A (2017) Noninvasive brain stimulation and personal identity: ethical considerations. Front Hum Neurosci 11:281. https://doi.org/10.3389/fnhum.2017.00281 CrossRefPubMedPubMedCentral

14.

Jung WH, Prehn K, Fang Z et al (2016) Moral competence and brain connectivity: a resting-state fMRI study. Neuroimage 141:408–415. https://doi.org/10.1016/j.neuroimage.2016.07.045 CrossRefPubMedPubMedCentral

15.

Porges SW (2003) The polyvagal theory: phylogenetic contributions to social behavior. Physiol Behav 79:503–513 Review.CrossRefPubMed

16.

Roldan Gerschcovich E, Cerquetti D, Tenca E, Leiguarda R (2011) The impact of bilateral cerebellar damage on theory of mind, empathy and decision making. Neurocase 17:270–275. https://doi.org/10.1080/13554791003730618 CrossRefPubMed

17.

Ray N, Antonelli F, Strafella AP (2011) Imaging impulsivity in Parkinson’s disease and the contribution of the subthalamic nucleus. Parkinsons Dis 2011:594860. https://doi.org/10.4061/2011/594860 PubMedPubMedCentralCrossRef

18.

Fumagalli M, Giannicola G, Rosa M et al (2011) Conflict-dependent dynamic of subthalamic nucleus oscillations during moral decisions. Soc Neurosci 6:243–256. https://doi.org/10.1080/17470919.2010.515148 CrossRefPubMed

19.

Del Tredici K, Braak H (2016) Review: sporadic Parkinson’s disease: development and distribution of α-synuclein pathology. Neuropathol Appl Neurobiol 42:33–50. https://doi.org/10.1111/nan.12298 CrossRefPubMed

20.

Santangelo G, Piscopo F, Barone P, Vitale C (2017) Personality in Parkinson’s disease: clinical, behavioural and cognitive correlates. J Neurol Sci 374:17–25. https://doi.org/10.1016/j.jns.2017.01.013 CrossRefPubMed

21.

Koerts J, Tucha L, Leenders KL, Tucha O (2013) Neuropsychological and emotional correlates of personality traits in Parkinson’s disease. Behav Neurol 27:567–574. https://doi.org/10.3233/BEN-129017 CrossRefPubMedPubMedCentral

22.

Santangelo G, Garramone F, Baiano C et al (2018) Personality and Parkinson’s disease: a meta-analysis. Parkinsonism Relat Disord https://doi.org/10.1016/j.parkreldis.2018.01.013 CrossRefPubMed

23.

Ishii T, Sawamoto N, Tabu H et al (2016) Altered striatal circuits underlie characteristic personality traits in Parkinson’s disease. J Neurol 263:1828–1839. https://doi.org/10.1007/s00415-016-8206-0 CrossRefPubMed

24.

Roca M, Torralva T, Gleichgerrcht E, Chade A, Arevalo GG, Gershanik O, Manes F (2010) Impairments in social cognition in early medicated and unmedicated Parkinson disease. Cogn Behav Neurol 23:152–158. https://doi.org/10.1097/WNN.0b013e3181e078de CrossRefPubMed

25.

Freedman M, Stuss D (2011) Theory of Mind in Parkinson’s disease. J Neurol Sci 310:225–227. https://doi.org/10.1016/j.jns.2011.06.004 CrossRefPubMed

26.

Poletti M, Vergallo A, Ulivi M et al (2013) Affective theory of mind in patients with Parkinson’s disease. Psychiat Clin Neuros 67:273–276. https://doi.org/10.1111/pcn.12045 CrossRef

27.

Xi C, Zhu Y, Mu Y et al (2015) Theory of mind and decision-making processes are impaired in Parkinson’s disease. Behav Brain Res 279:226–233. https://doi.org/10.1016/j.bbr.2014.11.035 CrossRefPubMed

28.

Péron J, Vicente S, Leray E et al (2009) Are dopaminergic pathways involved in theory of mind? A study in Parkinson’s disease. Neuropsychologia 47:406–414. https://doi.org/10.1016/j.neuropsychologia.2008.09.008 CrossRefPubMed

29.

Bodden M, Mollenhauer B, Trenkwalder C et al (2010) Affective and cognitive theory of mind in patients with parkinson’s disease. Parkinsonism Relat Disord 16:466–470. https://doi.org/10.1016/j.parkreldis.2010.04.014 CrossRefPubMed

30.

Díez-Cirarda M, Ojeda N, Peña J et al (2015) Neuroanatomical correlates of theory of mind deficit in Parkinson’s disease: a multimodal imaging study. Plos ONE 10:e0142234. https://doi.org/10.1371/journal.pone.0142234 CrossRefPubMedPubMedCentral

31.

Bora E, Walterfang M, Velakoulis D (2015) Theory of mind in Parkinson’s disease: a meta-analysis. Behav Brain Res 292:515–520. https://doi.org/10.1016/j.bbr.2015.07.012 CrossRefPubMed

32.

Rosen JB, Rott E, Ebersbach G, Kalbe E (2015) Altered moral decision-making in patients with idiopathic Parkinson’s disease. Parkinsonism Relat Disord 21(10):1191–1199. https://doi.org/10.1016/j.parkreldis.2015.08.016 CrossRefPubMed

33.

Cools R, D’Esposito M (2011) Inverted-U-shaped dopamine actions on human working memory and cognitive control. Biol Psychiatry 69:e113–e125. https://doi.org/10.1016/j.biopsych.2011.03.028 CrossRefPubMedPubMedCentral

34.

Weintraub D, Claassen D (2017) International review of neurobiology. Section 2a specific nonmotor symptoms. Parkinson’s Disord Part 1 133:679–717. https://doi.org/10.1016/bs.irn.2017.04.006 CrossRef

35.

Solla P, Bortolato M, Cannas A et al (2015) Paraphilias and paraphilic disorders in Parkinson’s disease: a systematic review of the literature. Mov Disord 30:604–613. https://doi.org/10.1002/mds.26157 CrossRefPubMedPubMedCentral

36.

Titova N, Chaudhuri KR (2017) Personalized medicine in Parkinson’s disease: time to be precise. Mov Disord 32:1147–1154. https://doi.org/10.1002/mds.27027 CrossRefPubMedPubMedCentral

37.

Schuepbach WMM, Rau J, Knudsen K et al (2013) Neurostimulation for Parkinson’s disease with early motor complications. N Engl J Med 368:610–622. https://doi.org/10.1056/NEJMoa1205158 CrossRefPubMed

38.

Claeys I, Santens P, Abbeele D, Van den et al (2013) A manic episode after bilateral subthalamic stimulation in a patient with advanced Parkinson’s disease. Acta Neuropsychiatr 25:367–369. https://doi.org/10.1017/neu.2013.30 CrossRefPubMed

39.

Evens R, Hoefler M, Biber K, Lueken U (2016) The Iowa gambling task in Parkinson’s disease: a meta-analysis on effects of disease and medication. Neuropsychologia 91:163–172. https://doi.org/10.1016/j.neuropsychologia.2016.07.032 CrossRefPubMed

40.

Florin E, Müller D, Pfeifer J et al (2013) Subthalamic stimulation modulates self-estimation of patients with Parkinson’s disease and induces risk-seeking behaviour. Brain 136(11):3271–3281. https://doi.org/10.1093/brain/awt241 CrossRefPubMed

41.

Schüpbach M, Gargiulo M, Welter ML et al (2006) Neurosurgery in Parkinson’s disease: a distressed mind in a repaired body? Neurology 66:1811–1816. https://doi.org/10.1212/01.wnl.0000234880.51322.16 CrossRefPubMed

42.

Cyron D (2016) Mental side effects of deep brain stimulation (DBS) for movement disorders: the futility of denial. Front Integr Neurosci 10:17. https://doi.org/10.3389/fnint.2016.00017 CrossRefPubMedPubMedCentral

43.

Fumagalli M, Marceglia S, Cogiamanian F et al (2015) Ethical safety of deep brain stimulation: a study on moral decision-making in Parkinson’s disease. Parkinsonism Relat Disord 21:709–716. https://doi.org/10.1016/j.parkreldis.2015.04.011 CrossRefPubMed

Title: The moral brain and moral behaviour in patients with Parkinson’s disease: a review of the literature
Authors: Patrick Santens
Giel Vanschoenbeek
Marijke Miatton
Miet De Letter
Publication date: 01-09-2018
Publisher: Springer International Publishing
Published in: Acta Neurologica Belgica / Issue 3/2018
Print ISSN: 0300-9009
Electronic ISSN: 2240-2993
DOI: https://doi.org/10.1007/s13760-018-0986-9

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The moral brain and moral behaviour in patients with Parkinson’s disease: a review of the literature

Abstract

Keynote webinar | Spotlight on medication adherence

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Abstract

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