Levodopa reverses gait asymmetries related to anhedonia and magical ideation

Abstract

Animals and men turn preferentially away from the hemisphere with the more active dopamine (DA) system. Consistent with the idea of a right-hemispheric hyperdopaminergia in schizophrenia, a leftsided turning bias was described for unmedicated psychotic patients. We investigated the modulating role of DA and schizophrenia-like thought on whole-body turns in a controlled double-blind study. The number of veers to either side when walking blindfolded straight ahead (20 meter) was assessed in 40 healthy righthanded men (20 men received levodopa, the remaining participants placebo). Side preferences were analyzed in terms of individuals' positive (Magical Ideation, MI) and negative (Physical Anhedonia, PhysAn) schizotypal features. In the placebo group, increasing MI scores were related to increasing left-sided veering and increasing PhysAn scores were related to increasing right-sided veering. In the levodopa group, this relationship between preferred veering side and type of schizotypy was reversed. The finding in the placebo group suggests an association between MI and a relative right-hemispheric hyperdopaminergia. Unexpectedly, levodopa did not enhance this veering bias, but reversed it, suggesting that psychosis-protective mechanisms exist in the healthy positive "schizotypic" brain. Also unexpectedly, levodopa made "anhedonics" veer like "magics" after placebo, suggesting that DA agonists suppress negative schizotypal symptoms.