Selective attention is insensitive to reward and to dopamine in Parkinson's disease

Abstract

Patients with Parkinsons disease exhibit reduced reward sensitivity in addition to early cognitive deficits, among which attention impairments are common. Attention allocation is controlled at multiple levels and recent work has shown that reward, in addition to its role in the top-down goal-directed control of attention, also guides the automatic allocation of attention resources, a process thought to rely on striatal dopamine. Whether Parkinsons patients, due to their striatal dopamine loss, suffer from an inability to use reward information to guide the allocation of their attention is unknown. To address this question, we tested Parkinsons patients (n=43) ON and OFF their dopaminergic medication, and compared them to a group of older controls (n=31). We used a standard two-phase attention capture task in which subjects were first implicitly trained to make colour-reward associations. In the second phase, the previously reward-associated colours were used as distractors in a visual search task. We found that patients did not use reward information to modulate their attention; they were similarly distracted by the presence of low and high-reward distractors. However, contrary to our predictions, we did not find evidence that dopamine modulated this inability to use reward to guide attention allocation. Additionally, we found slightly increased overall distractibility in Parkinsons patients compared to older controls, but interestingly, the degree of distractibility was not influenced by dopamine replacement. Our results suggest that loss of reward-guided attention allocation may contribute to early attention deficits and raise the possibility that this inability to prioritize cognitive resource allocation could contribute to executive deficits more broadly in Parkinsons disease.