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

Published online by Cambridge University Press:  07 March 2017

Michele Poletti
Michele Poletti*
Affiliation:
Department of Mental Health and Pathological Addiction, Azienda Unità Sanitaria Locale Reggio Emilia, Reggio nell’Emilia, Italy
*
*Address for correspondence: Michele Poletti, Department of Mental Health and Pathological Addiction, AUSL of Reggio Emilia, Via Amendola 2, 52100, Reggio Emilia, Italy. (Email: michele.poletti2@ausl.re.it)
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Abstract

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.

Keywords

Dopamine agonistsaberrant salienceimpulse control disorderspsychosiscreativity
Type
Opinions
Information
CNS Spectrums , Volume 23 , Special Issue 6: Theme: Neuropsychiatry , December 2018 , pp. 347 - 351
Copyright
© Cambridge University Press 2017 

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