Objective: To explore novelty seeking (NS) as a construct, in both its adaptive and maladaptive roles, in order to provide insight into the cognitive and behavioral changes that occur in Parkinson’s Disease (PD) and inspire new avenues for diagnostic or therapeutic intervention in these patients.

Background: PD is a complex neurodegenerative condition characterized not only by motor disability but also by cognitive and affective changes. The “Parkinson’s personality” is sometimes utilized to describe patients’ premorbid traits of inflexibility, orderliness, introversion, cautiousness, and punctuality. Though there is little agreement on a unified description of PD personality, novelty-seeking (NS) has emerged as a biologically-relevant trait. NS represents a dimension of temperament which increases exploratory behavior when stimuli are new or different.

Method: A narrative review of all the relevant papers known to the author was conducted, applying Cloninger’s Tridimensional Personality Questionnaire to determine potential for tailored therapies in PD.

Results: Cloninger’s model of personality was based on heritable differences in monoamine neurotransmitter receptor polymorphisms and inspired rat models which continue to demonstrate construct validity in the study of human NS traits as evidenced by the recent applications of a human Behavioral Pattern Monitor.  NS is generally low in early disease and increases with advancing disease and increasing dopaminergic therapy. NS has significant associations with addiction and impulse control disorders (ICDs) and intersects with several other neuropsychiatric conditions. New treatments for ICDs have failed to enter routine clinical practice, but psychedelics are now being studied in addiction with some promising results. The recent identification of the zona incerta as a unique driver of NS, independent of reward, also implicates deep brain stimulation in the treatment of ICD

Conclusion: As a dynamic feature of the “Parkinson’s personality,” influenced both by disease state and medications, NS offers a unique window into the study of PD patients and has an adaptive role beyond its associations with impulsivity.

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