Preserved Aesthetic Judgements in Parkinson's Disease: A Case-Control Study Suggests Limited Need for Content...

Background/Objectives: Parkinson's disease (PD) is increasingly recognized as a multisystem disorder affecting perceptual, emotional, and reward-related processes. While arts-based interventions in PD have primarily focused on active creative arts engagement, it remains unclear whether receptive arts engagement with visual art-how artworks are perceived and evaluated-is altered. Our objective is to determine whether aesthetic evaluation of visual artworks differs in individuals with PD compared to age-matched healthy controls. We further examine whether emotional interpretation, color-emotion associations, and experiential responses to art viewing are altered. Methods: In a cross-sectional case-control study, individuals with PD (n = 87) and age-matched healthy controls (n = 49) completed two online assessments. Participants evaluated 36 artworks from the Vienna Art Picture System in terms of liking, beauty, and subjective art attributes. Objective image-derived features were computed for each artwork. Interpretable machine learning models were used to test whether evaluation patterns predicted diagnostic group and to identify determinants of aesthetic judgments. Participants further completed a color-emotion association task using ambiguous expressive portraits and reported perceived changes in cognitive, emotional, motivational, and physical states following art viewing. Results: Aesthetic evaluation patterns did not support reliable classification of PD status, indicating no systematic group differences in liking, beauty, or attribute-based judgments between PD and controls. Instead, aesthetic judgments were robustly predicted by individual differences and objective artwork properties, including art-historical style, symmetry, complexity, and color-related features, whereas diagnostic group, gender, and age did not contribute to predictions. Emotional interpretation and color-emotion associations were largely comparable between groups, with a single specific deviation in color-emotion mapping. Positive emotions were less frequently associated with pink in people with PD. Self-reported experiential responses to art viewing did not differ significantly between groups. Conclusions: Aesthetic evaluation of visual artworks appears largely preserved in people with PD. These findings suggest that, in digital viewing contexts, substantial adaptation of visual content to make it accessible for people with PD may not be necessary, although subtle perceptual and emotional differences may still be relevant. Efforts may instead be better directed toward addressing practical barriers to visual art engagement.