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The dark side of dopaminergic therapies in Parkinson’s disease: shedding light on aberrant salience

机译：多巴胺能疗法在帕金森病的黑暗面：脱落在异常的壮丽

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摘要

Psychotic subjects and patients with Parkinson’s disease (PD) “on” dopaminergic drugs, especially on dopamine agonists, present a hyperdopaminergic state that interferes with learning processing. These clinical populations present with distinct alterations of learning that share an increased potential motivational significance of stimuli: psychotic subjects may attribute salience to neutral stimuli, while medicated PD patients may overvalue rewards. Herein is discussed the speculative hypothesis that the hyperdopaminergic state induced by dopaminergic treatments, especially with dopamine agonists, may also facilitate the attribution of salience to neutral stimuli in PD patients, altering the physiological attribution of salience. Preliminary empirical evidence is in agreement with this speculative hypothesis, which needs further empirical investigation. The clinical implications of this hypothesis are discussed in relation to behavioral addictions, psychosis proneness, and enhanced creativity in medicated PD patients.
机译：精神病受试者和帕金森病（PD）“对”多巴胺能药物，特别是在多巴胺激动剂上的患者呈现出一种干扰学习加工的高原霉素能状态。这些临床群体存在具有不同的学习改变，这些刺激的潜在动机意义增加：精神病受试者可能将显着性归因于中性刺激，而药物PD患者可能会估计奖励。讨论了由多巴胺能治疗，特别是多巴胺激动剂诱导的高原胺能状态，特别是与多巴胺激动剂，也可以促进PD患者中刺激的归因，改变显着的生理归因。初步经验证据符合这一投机性假设，需要进一步的实证调查。该假设的临床意义是关于含药PD患者的行为上瘾，精神病的幂性和增强的创造力而讨论的。

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