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The current study investigates the interaction of reward processing variables, dopaminergic therapy, and risky decision-making and subjective feelings in patients with versus without ICD. Patients with (n\u2009=\u200918) and without (n\u2009=\u200912) ICD performed a risky decision-making task both \u2018on\u2019 and \u2018off\u2019 standard-of-care dopaminergic therapies (the task was performed on 2 different days with the order of on and off visits randomized for each patient). During each trial of the task, participants choose between two options, a gamble or a certain reward, and reported how they felt about decision outcomes. Subjective feelings of \u2018pleasure\u2019 are differentially driven by expectations of possible outcomes in patients with, versus without ICD. While off medication, the influence of expectations about risky-decisions on subjective feelings is reduced in patients with ICD versus without ICD. While on medication, the influence of expected outcomes in patients with ICD versus without ICD becomes similar. Computational modeling of behavior supports the idea that latent decision-making factors drive subjective feelings in patients with Parkinson\u2019s disease and that ICD status is associated with a change in the relationship between factors associated with risky behavior and subjective feelings about the experienced outcomes. Our results also suggest that dopaminergic medications modulate the impact expectations have on the participants' subjective reports. Altogether our results suggest that expectations about risky decisions may be decoupled from subjective feelings in patients with ICD, and that dopaminergic medications may reengage these circuits and increase emotional reactivity in patients with ICD.<\/jats:p>","DOI":"10.1038\/s41598-024-53076-2","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T06:01:41Z","timestamp":1709532101000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Subjective feelings associated with expectations and rewards during risky decision-making in impulse control disorder"],"prefix":"10.1038","volume":"14","author":[{"given":"Brittany","family":"Liebenow","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily K.","family":"DiMarco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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He has consulted for compensation for Boston Scientific and Medtronics. Dr. Mustafa Siddiqui has received research support as a site Principal Investigator for clinical trials from Neuraly, University of Rochester, Michael J. Fox-Neuropoint Alliance, Theravance Biopharma, Impax Laboratories, Sun Pharma, Abbvie, Boston Scientific Neuromodulation, Biogen and Sunovion. He has received honoraria as a scientific advisor from Abbvie and Boston Scientific Neuromodulation. Dr. Adrian Laxton is a consultant and member of the safety committee for Monteris Medical. All other authors have nothing to disclose.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"4627"}}