Reversal learning in Parkinson's disease depends on medication status and outcome valence

Neuropsychologia. 2006;44(10):1663-73. doi: 10.1016/j.neuropsychologia.2006.03.030. Epub 2006 May 26.


We investigated the role of dopamine in distinct forms of reversal shifting by comparing two groups of patients with mild Parkinson's disease (PD), one ON and one OFF their normal dopaminergic medication. In accordance with our previous work, patients ON medication exhibited impaired reversal shifting relative to patients OFF medication. The present results extend previous studies by showing that the medication-induced deficit on reversal shifting was restricted to conditions where reversals were signaled by unexpected punishment. By contrast, patients ON medication performed as well as patients OFF medication and controls when the reversal was signaled by unexpected reward. The medication-induced deficit was particularly pronounced in patients on the dopamine D3 receptor agonist pramipexole. These data indicate that dopaminergic medication in PD impairs reversal shifting depending on the motivational valence of unexpected outcomes.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Analysis of Variance
  • Antiparkinson Agents / adverse effects*
  • Benzothiazoles
  • Case-Control Studies
  • Female
  • Humans
  • Learning Disabilities / chemically induced
  • Male
  • Middle Aged
  • Neuropsychological Tests / statistics & numerical data
  • Outcome Assessment, Health Care*
  • Parkinson Disease / drug therapy
  • Parkinson Disease / physiopathology*
  • Pramipexole
  • Reversal Learning / drug effects*
  • Thiazoles / adverse effects*


  • Antiparkinson Agents
  • Benzothiazoles
  • Thiazoles
  • Pramipexole