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Reward learning deficits in Parkinson's disease depend on depression

  • M. H. M. Timmer (a1) (a2), G. Sescousse (a1), M. E. van der Schaaf (a1), R. A. J. Esselink (a2) and R. Cools (a1) (a3)...

Depression is one of the most common and debilitating non-motor symptoms of Parkinson's disease (PD). The neurocognitive mechanisms underlying depression in PD are unclear and treatment is often suboptimal.


We investigated the role of striatal dopamine in reversal learning from reward and punishment by combining a controlled medication withdrawal procedure with functional magnetic resonance imaging in 22 non-depressed PD patients and 19 PD patients with past or present depression.


PD patients with a depression (history) exhibited impaired reward v. punishment reversal learning as well as reduced reward v. punishment-related BOLD signal in the striatum (putamen) compared with non-depressed PD patients. No effects of dopaminergic medication were observed.


The present findings demonstrate that impairments in reversal learning from reward v. punishment and associated striatal signalling depend on the presence of (a history of) depression in PD.

Corresponding author
*Address for correspondence: M. H. M. Timmer, M.D., Department of Neurology (HP 935), Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands. (Email:
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