Abstract

Cognitive deficits are a recognised component of Parkinson’s disease (PD). However, particularly within the domain of short-term memory, it is unclear whether these impairments are masked, or caused, by patients’ dopaminergic medication. The effect of medication on pure maintenance in PD patients has rarely been explored, with most assessments examining maintenance intercalated between other executive tasks. Moreover, few studies have utilised methods that can measure the quality of mental representations, which can enable the decomposition of recall errors into their underlying neurocognitive components. Here, we fill this gap by examining pure maintenance in PD patients in high and low dopaminergic states. Participants had to encode the orientation of two stimuli and reproduce these orientations after a short (2 s) or long (8 s) delay. In addition, we also examined the performance of healthy, age-matched older adults to contextualise these effects and determine whether PD represents an exacerbation of the normal ageing process. Patients showed improved recall OFF compared to ON their dopaminergic medication, but only for long-duration trials. Moreover, PD patients OFF their medication actually performed at a level superior to age-matched controls, indicative of a paradoxical enhancement of memory in the low dopaminergic state. The application of a probabilistic model of response selection suggested that PD patients made fewer misbinding errors in the low, compared with high, dopaminergic state for longer-delay trials. Thus, unexpectedly, the mechanisms that prevent memoranda from being corrupted by misbinding over time appear to be enhanced in PD patients OFF dopaminergic medication. Possible explanations for this paradoxical effect are discussed.

Highlights

  • IntroductionResearchers have attempted to isolate the role of dopamine in causing cognitive control impairments in Parkinson’s disease (PD) by testing patients ON and OFF their dopamine-enhancing medication.[15,16,17,18] In the field of working memory (WM), these studies have produced conflicting results

  • Medication state had a significant main effect on recall (F (1,38) = 10.48, p = 0.004, ω2 = 0.039) with patients OFF their dopaminergic medication showing significantly improved recall compared with patients ON their medication

  • Rather than showing superior performance ON dopaminergic medication, patients’ recall was significantly enhanced, in a delay-dependent manner, when they were OFF medication

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Summary

Introduction

Researchers have attempted to isolate the role of dopamine in causing cognitive control impairments in PD by testing patients ON and OFF their dopamine-enhancing medication.[15,16,17,18] In the field of working memory (WM), these studies have produced conflicting results. Researchers have attempted to account for these divergent findings by hypothesising that dopaminergic medication can have separate, possibly opposing effects, on different mnemonic subprocesses. Impairments in the proficiency of manipulating information ( updating WM contents or protecting them from distractors—ignoring) were found to be ameliorated by dopaminergic medication.[24] by using delayed, analogue report measures—in which the features of a memoranda (e.g., orientations) need to be reproduced—it was possible to apply a computational model to uncover the source of these errors

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