Abstract
Reversal learning (RL) has been widely used for assessment of behavioral adaptation, impulsivity, obsession, and compulsion in healthy controls as well as people suffering from psychiatric and neurological disorders such as Parkinson’s disease (PD). Nevertheless, studies addressing high cognitive functions such as metacognition in PD are scarce. Here, we address for the first time the effect of levodopa and PD on metacognition within the framework of a RL paradigm. In agreement with previous reports, PD patients exhibited reversal shifting impairment with respect to healthy controls (CTRL) regardless of medication condition (MED-ON and MED-OFF), which was supported by a well-known model of learning conditioning (Rescorla–Wagner). In spite that we found a significant association between accuracy and decision confidence level for MED-OFF and CTRL, analysis of metacognitive sensitivity assessed by type 2 signal detection theory (SDT) revealed only a significant underperformance for patients without medication (MED-OFF). This finding points toward a non-compromising positive effect of dopaminergic medication on metacognition for PD.
Highlights
Dopaminergic medication and deep brain stimulation (DBS) are established treatments for Parkinson’s disease (PD), which provide sustained motor effects (Groiss et al, 2009; Vijverman and Fox, 2014) and have been implicated in modulating cortico-striatal circuitry with an indirect effect in cognitive and behavioral abilities (Calabresi et al, 2015; Da Cunha et al, 2015)
The present study addressed for the first time the effect of levodopa and PD on metacognition within the framework of a reversal learning (RL) paradigm
In agreement with previous reports that stressed impairment of behavioral adaptation in PD patients (Cools et al, 2002; Peterson et al, 2009), we found an effect of PD as reflected in RL behavioral parameters
Summary
Dopaminergic medication and deep brain stimulation (DBS) are established treatments for Parkinson’s disease (PD), which provide sustained motor effects (Groiss et al, 2009; Vijverman and Fox, 2014) and have been implicated in modulating cortico-striatal circuitry with an indirect effect in cognitive and behavioral abilities (Calabresi et al, 2015; Da Cunha et al, 2015). In order to address behavioral adaptation in PD patients, previous studies considered adaptation toward reward contingency changes by using a probabilistic reversal learning (RL) task. Such task requires subjects to discriminate between two stimuli on the basis of feedback with a specified probabilistic error and continuous monitoring of contingency changes (reversals). It has been reported that l-dopa impairs performance and facilitates task-switching (Swainson et al, 2000; Cools et al, 2001), while other studies emphasized enhancement of reward seeking behavior and RL impairment (Graef et al, 2010).
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