Objective: Study of the emotional mirroring and its modulation by levodopa treatment in fluctuating PD patients with no significant cognitive burden as assessed by regular neuropsychological testing.

Background: Social cognition is a complex system relying on emotional recognition (mirroring), the theory of mind (TOM), but also on the sociocultural environment.The first step in this model is the emotional mirroring which seems to be altered in PD patients. However results are discordant because differents tasks are used to test the “primitive” mirror neurons system (involved in the emotional recognition) and it seems difficult to avoid interferences with the TOM, which is the next level of social cognition. The psychocognitive status but also the PD treatment modulate social cognition.

Method: In this prospective study (ClinicalTrials.gov Identifier: NCT03004573) we enrolled, between 2017 and 2018, 27 PD fluctuating patients already qualified for STN DBS surgery. One month before surgery a detailed psychocognitive check-up was performed: evaluation of anxiety, depression, apathy, general cognitive performance, frontal and visuospatial functions. As for the social cognition, we used the moving dots scenes for the emotional mirroring and the classical evaluation of the TOM with the face recognition and the TOM-15 (false-belief task). In order to further understand the role of levodopa, the social cognition evaluation was performed in OFF and ON treatment.

Results: Our first results clearly suggest that the administration of levodopa can have a dramatically positive or negative role on the handling of the emotional recognition, but also on the higher level of social cognition like the theory of mind. It seems to be minor correlation between the classical neuropsychological evaluation and the positive or negative role of levodopa on the social cognition performance.

Conclusion: PD and levodopa modify the social cognition performance and this probably explains the complex social, professional and familial modifications that occur very rapidly even in patients without cognitive deficits. Our 27 patients are currently evaluated in order to evaluate the role of the STN DBS surgery on the social cognition. Further combined studies (cognition, imagistics, metabolic, genetics) are clearly needed in order to understand the mechanisms underlying these modifications and maybe adapt treatments following different social cognition status.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impaired-fonction-of-mirror-neurons-and-the-role-of-levodopa-in-pd-patients/