Effects of tDCS on reward responsiveness and valuation in Parkinson's patients with impulse control disorders

Parkinson's disease (PD) patients with impulse control disorders (ICD) frequently report hypersensitivity to rewards. However, a few studies have explored the effectiveness of modulation techniques on symptoms experienced by these patients. In this study, we assessed the effect of anodal tDCS over the DLPFC on reward responsiveness and valuation in PD patients with ICD. 43 participants (15 PD patients with ICD, 13 PD without ICD, and 15 healthy matched controls) were asked to perform a reward-craving test employing both explicit (self-ratings of liking and wanting) and implicit (heart rate and skin conductance response) measures, as well as two temporal discounting tasks with food and money rewards. Each participant performed the experimental tasks during active anodal tDCS of the left dorsolateral prefrontal cortex (DLPFC), anodal tDCS of the primary motor cortex (M1), and sham tDCS. Results showed increased wanting and a steeper temporal discounting of rewards in PD with ICD compared to the other groups. Moreover, we found that PD without ICD exhibit reduced liking for rewards. tDCS results capable to modulate the altered intensity of PD patients' liking, but not wanting and temporal discounting of rewards in PD patients with ICD. These findings confirm that alterations in reward responsiveness and valuation are characteristics of impulse control disorders in patients with PD but suggest that anodal tDCS over the left DLPFC is not capable to influence these processes. At the same time, they provide new insight into affective experience of rewards in PD.