Dopaminergic Basis of Spatial Deficits in Early Parkinson’s Disease

Abstract

\n Dopaminergic mechanisms regulating cognitive and motor control were evaluated comparing visuoperceptual and perceptuomotor functions in Parkinson’s disease (PD). The performance of PD patients (n\u2009=\u200940) was contrasted with healthy controls (n\u2009=\u200942) across two separate visits (on and off dopaminergic medications) on computerized tasks of perception and aiming to a target at variable stimulus lengths (4, 8, 12\xa0cm). Novel visuoperceptual tasks of length equivalence and width interval estimations without motor demands were compared to tasks estimating spatial deviation in movement termination. The findings support the presence of spatial deficits in early PD, more pronounced with increased discrimination difficulty, and with shorter stimulus lengths of 4\xa0cm for both visuoperceptual and perceptumotor functions. Dopaminergic medication had an adverse impact on visuoperceptual accuracy in particular for length equivalence estimations, contrasted with dopaminergic modulation of perceptuomotor functions by reducing angular displacements towards the target. The differential outcomes for spatial accuracy in perception versus movement termination in PD is consistent with involvement of the direct pathway and models of progressive loss of dopamine through corticostriatal loops. Future research should develop validated and sensitive standardized tests of perception and explore dopaminergic selective deficits in PD to optimize medication titration for motor and cognitive symptoms of the disease.