Objective: Better understand the social interactions by assessing the effect of oral levodopa on the social cognition abilities in fluctuating PD patients without significant cognitive disorder.

Background: Parkinson’s disease (PD) is usually responsible of cognitive and behavioral difficulties, with a major impact on the quality of life. Among them, social cognition is a complex process supported by multiple mechanisms, including emotional recognition (through the mirror neurons system), theory of mind (ToM), socio-cultural level, mood, experience, social environment.

Method: In this prospective study, we enrolled 36 fluctuating, non-demented PD patients, candidates for subthalamic deep brain stimulation (STN-DBS) and 14 matched healthy controls. Participants were asked to rate the emotional valence (positive, negative or neutral) of 15 videos depicting emotional interactions presented with the « Point Light Displays » technique, in OFF and ON levodopa medication. We also evaluated the ToM performances in the same conditions.

Results: PD patients’ ratings in OFF levodopa condition were significantly lower for positive movies and higher (less negative) for negative movies, compared to healthy control (p =0.0296 and p=0.0252 respectively). In contrast, movies ratings in ON levodopa condition are close to those of healthy control. Concerning the ToM items, our group of PD patients had performances (11.1 +/- 2.51) inferior to the normal range on the faux pas’ test in both pharmacological conditions, while the performances on the emotional facial recognition test were within normal range, underlining a probable early frontal dysfunction ignored by usual neuropsychological testing.

Conclusion: In conclusion, the administration of oral L-Dopa enhances the amplitude of the emotional acuity of PD patients to analyze motor interactions. The blunted valence ratings for both positive and negative emotions observed in PD patients seems to be the expression of a dysfunction of the embodied simulation process as suggested by the mirror neurons system.

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2. Poletti M, Enrici I, Adenzato M. Cognitive and affective Theory of Mind in neurodegenerative diseases: neuropsychological, neuroanatomical and neurochemical levels. Neurosci Biobehav Rev. 2012;36(9):2147-2164. doi:10.1016/j.neubiorev.2012.07.004
3. Bodden ME, Dodel R, Kalbe E. Theory of mind in Parkinson’s disease and related basal ganglia disorders: A systematic review: Theory of Mind in Parkinson’s Disease. Mov Disord. 2010;25(1):13-27. doi:10.1002/mds.22818
4. Bellot E, Garnier-Crussard A, Pongan E, Delphin-Combe E, Coste MH, Gentil C, Rouch I, Hénaff MA, Schmitz C, Tillmann B, Krolak-Salmon P. Blunted emotion judgments of body movements in Parkinson’s disease. Sci Rep. 2021 Sep 17;11(1):18575. doi: 10.1038/s41598-021-97788-1.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-levodopa-on-the-interpretation-of-social-interactions-in-people-living-with-parkinsons-disease/