Working memory in Parkinson's disease patients: clinical features and response to levodopa.

OBJECTIVE: To evaluate the clinical features of the working memory (WM) in Parkinson's disease (PD) patients and to test the effect of levodopa on WM. METHOD: The paradigm was based on the 'n-back' tasks, which enables to study the level of executive demand (three levels of difficulty) and the domain of the information being processed (spatial items, faces and letters). The effect of levodopa was studied by testing PD patients in "on" and "off" states. RESULTS: PD patients performed less well in WM tasks than controls. There was no interaction between groups and complexity. Levodopa therapy had a positive effect only on spatial WM tasks but no effect on complexity. CONCLUSION: Our results suggest that impairment observed may result from a maintenance deficit within WM regardless the level of processing and levodopa therapy presents a positive effect on spatial WM.

Effects of internal clock and memory disorders on duration reproductions and duration productions in patients with Parkinson's disease.

Patients with Parkinson's disease (PD) exhibit deficits in perceptual and motor timing as well as impairments in memory and attentional processes that are related to dysfunction of dopaminergic systems in the basal ganglia. The aim of the present study was to assess the relationships existing between impaired duration judgments and defective memory and attention in PD patients. We compared time performance of medicated PD patients and control subjects on a duration reproduction task that is highly memory-dependent, and on a duration production task that could reveal effects of changes in the speed of internal time-keeping mechanisms. Each task was performed in a control counting condition and in a condition requiring divided attention between the temporal task and a concurrent reading task. Moreover, PD patients and control subjects were assessed on memory and attention using a battery of neuropsychological tests. The results revealed that in the concurrent reading condition of the reproduction task, duration judgments tended to be more variable in PD patients than in control subjects. Moreover, variability of duration reproductions was correlated with both measures of memory and of disease severity. In the concurrent reading condition of the production task, duration judgments were significantly shorter in PD patients than in control subjects, and accuracy of duration productions was correlated with scores on sub-tests of short-term memory. The findings suggest that the administration of dopamine did not entirely remove the memory deficits in PD patients. Moreover, DA treatment would have abnormally accelerated the rate of the internal clock leading to shorter duration productions in PD patients. The whole results indicate that dopamine administration in patients might have overshadowed the slowing rate of the internal clock usually reported in non medicated PD patients, without entirely restoring all of the memory functions.

Separating storage from retrieval dysfunction of temporal memory in Parkinson's disease.

Dysfunction of the basal ganglia and the brain nuclei interconnected with them leads to disturbances of movement and cognition exemplified in Parkinson's disease (PD) and Huntington's disease, including disordered timing of movements and impaired time estimation. Previous research has shown that whereas striatal damage in animals can result in the loss of temporal control over behavior, dopaminergic deregulation in the human striatum associated with PD distorts the memory for time. Here we show a dissociation between deficits in storage (writing to) and retrieval (reading from) temporal memory processes. Both are dysfunctional in PD and sensitive to treatment with dopaminergic agents, but produce dissimilar distortions. When time intervals are stored in memory while the subjects are dopamine depleted, the process is slowed, leading to overestimation of two different time intervals. Conversely, when retrieval occurs in a dopamine-depleted state, interference or coupling occurs between two remembered time intervals, producing overestimation of the shorter and underestimation of the longer one. Whether those two separable patterns of dysfunction in storing and retrieving temporal memories rely on distinct neural networks within the basal ganglia and/or their cortical targets remains to be answered by future research.

Procedural learning and striatofrontal dysfunction in Parkinson's disease.

The neural basis of procedural learning remains controversial. We further analyzed procedural learning in nondemented patients with Parkinson's disease (PD) according to the specific demands of the tasks and the severity of striatal and frontal lobe dysfunction. In the first experiment, the performance of 20 nondemented PD patients and matched normal control subjects was studied in two procedural learning tasks, rotor pursuit and mirror reading, that differ in terms of motor and cognitive involvement. A second experiment further assessed the relationship between learning in mirror reading and executive functions in a new group of 15 nondemented PD patients. In rotor pursuit, PD patients significantly progressed across the first sessions, although their asymptotic performance was inferior to that of controls. In mirror reading, both experiments showed substantial learning in PD patients considered as a group. However, subsequent analyses allowed us to distinguish PD patients without executive dysfunction, whose learning was normal, from PD patients with executive dysfunction, whose learning was severely impaired. These results confirm the involvement of striatofrontal circuits in procedural learning and indicate that the intervention of the frontal network may depend on the characteristics of the task.

Working memory in Parkinson's disease patients: clinical features and response to levodopa / Memória de trabalho em pacientes com doença de Parkinson: características clínicas e resposta a levodopa

OBJECTIVE: To evaluate the clinical features of the working memory (WM) in Parkinson's disease (PD) patients and to test the effect of levodopa on WM. METHOD: The paradigm was based on the 'n-back' tasks, which enables to study the level of executive demand (three levels of difficulty) and the domain of the information being processed (spatial items, faces and letters). The effect of levodopa was studied by testing PD patients in "on" and "off" states. RESULTS: PD patients performed less well in WM tasks than controls. There was no interaction between groups and complexity. Levodopa therapy had a positive effect only on spatial WM tasks but no effect on complexity. CONCLUSION: Our results suggest that impairment observed may result from a maintenance deficit within WM regardless the level of processing and levodopa therapy presents a positive effect on spatial WM.

OBJETIVO: Avaliar as características clínicas da memória de trabalho (MT) em pacientes com doença de Parkinson (DP) e testar o efeito da levodopa na MT. MÉTODO: O paradigma baseou-se nas tarefas 'n-back', que permitem avaliar o nível de demanda executiva (três níveis de dificuldade) e o domínio da informação sendo processado (posições espaciais, faces e letras). O efeito da levodopa foi estudado pela testagem dos pacientes no estado "on" e "off". RESULTADOS: Pacientes com DP apresentam desempenho inferior ao dos controles em tarefas de MT. Não foi observada interação entre grupos e complexidade. A terapia com levodopa mostrou efeito positivo sobre a modalidade espacial, e nenhum efeito sobre a complexidade. CONCLUSÃO: Nossos resultados sugerem que o comprometimento observado pode resultar de défict de manutenção da MT, independente do nível de processamento. A terapia com levodopa apresenta efeito positivo sobre a MT espacial.