L-Dopa medication remediates cognitive inflexibility, but increases impulsivity in patients with Parkinson's disease

Neuropsychologia. 2003;41(11):1431-41. doi: 10.1016/s0028-3932(03)00117-9.


In the current study we investigated the role of dopamine in attentional and socio-emotional functioning by examining effects of withdrawing dopaminergic medication in patients with Parkinson's disease (PD). Patients "on" medication exhibited abnormal betting strategies on a task of decision-making, reflecting impulsive behaviour and/or delay aversion, whilst the same patients "off" medication exhibited abnormally increased switch costs when switching between two tasks, reflecting attentional inflexibility. Hence, these data replicate and extend previous findings that dopaminergic medication improves or impairs cognitive performance depending on the nature of the task and the basal level of dopamine function in underlying cortico-striatal circuitry.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antiparkinson Agents / administration & dosage*
  • Attention / drug effects
  • Choice Behavior / drug effects
  • Cognition / drug effects*
  • Decision Making / drug effects*
  • Drug Administration Schedule
  • Female
  • Humans
  • Impulsive Behavior / physiopathology
  • Levodopa / administration & dosage*
  • Male
  • Matched-Pair Analysis
  • Middle Aged
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / physiopathology
  • Psychomotor Performance / drug effects


  • Antiparkinson Agents
  • Levodopa