Attention and reinforcement learning in Parkinson's disease

Dopamine is known to be involved in several important cognitive processes, most notably in learning from rewards and in the ability to attend to task-relevant aspects of the environment. Both of these features of dopaminergic signalling have been studied separately in research involving Parkinsons disease (PD) patients, who exhibit diminished levels of dopamine. Here, we tie together some of the commonalities in the effects of dopamine on these aspects of cognition by having PD patients (ON and OFF dopaminergic medication) and healthy controls (HCs) perform two tasks that probe these processes. Within-patient behavioural measures of distractibility, from an attentional capture task, and learning performance, from a probabilistic classification reinforcement learning task, were included in one model to assess the role of distractibility during learning. Dopamine medication state and distractibility level were found to have an interactive effect on learning performance; less distractibility in PD ON was associated with higher accuracy during learning, and this was altered in PD OFF. Functional magnetic resonance imaging (fMRI) data acquired during the learning task furthermore allowed us to assess multivariate patterns of positive and negative outcomes in fronto-striatal and visual brain regions involved in both learning processes and the executive control of attention. Here, we demonstrate that while PD ON show a clearer distinction between outcomes than OFF in dorsolateral prefrontal cortex (DLPFC) and putamen, PD OFF show better distinction of activation patterns in visual regions that respond to the stimuli presented during the task. These results demonstrate that dopamine plays a key role in modulating the interaction between attention and learning at the level of both behaviour and activation patterns in the brain.