How attentional boost interacts with reward: the effect of dopaminergic medications in Parkinson's disease

There is widespread evidence that dopamine is implicated in the regulation of reward and salience. However, it is less known how these processes interact with attention and recognition memory. To explore this question, we used the attentional boost test in patients with Parkinson's disease (PD) before and after the administration of dopaminergic medications. Participants performed a visual letter detection task (remembering rewarded target letters and ignoring distractor letters) while also viewing a series of photos of natural and urban scenes in the background of the letters. The aim of the game was to retrieve the target letter after each trial and to win as much virtual money as possible. The recognition of background scenes was not rewarded. We enrolled 26 drug-naïve, newly diagnosed patients with PD and 25 healthy controls who were evaluated at baseline and follow-up. Patients with PD received dopamine agonists (pramipexole, ropinirole, rotigotine) during the 12-week follow-up period. At baseline, we found intact attentional boost in patients with PD: they were able to recognize target-associated scenes similarly to controls. At follow-up, patients with PD outperformed controls for both target- and distractor-associated scenes, but not when scenes were presented without letters. The alerting, orienting and executive components of attention were intact in PD. Enhanced attentional boost was replicated in a smaller group of patients with PD (n = 15) receiving l-3,4-dihydroxyphenylalanine (L-DOPA). These results suggest that dopaminergic medications facilitate attentional boost for background information regardless of whether the central task (letter detection) is rewarded or not.