Attentional Performance in Parkinson Disease

Parkinson's Disease

Functional Connectivity, Visual Attention, Dopamine Depletion, Landmark Test

Background: Parkinson Disease (PD) is a nervous system disorder that affects movement. Dopamine is an important neurotransmitter in the brain. As PD progresses, there is less and less dopamine in the brain. Researchers think there may be a relationship between differences in attention and dopamine in people with PD. Objective: To learn if people with PD that is worse on one side also have differences in how much attention they pay to the two sides of space on their left and right. Eligibility: English-speaking, right-handed people age 35-80 with PD. Design: Participants will be screened with medical and neurological history and exam, and medicine review. Participants will have 1 study visit. It will last 7-8 hours. They will stop taking their Parkinson medicine 12 hours before the visit. Participants will complete questionnaires. Participants will do tasks on a computer screen. They will judge the middle of lines, react to stimuli, and search and identify items that appear on the screen. Participants may have functional and structural magnetic resonance imaging (MRI). MRI uses a strong magnetic field and radio waves to take pictures of the brain. During the MRI, participants will lie on a table that slides in and out of the MRI scanner. While inside the scanner, they will look at a cross on a screen, relax, and think about nothing. Participants will undergo prism adaptation. They will sit in front of a board while their chin rests on a support. They will point to 1 of 2 dots on the board while they wear prism glasses that shift their vision to the left or right....

Study Description: We will investigate the relationship between Dopamine (DA) function and attention in patients with asymmetric Parkinson Disease (PD). We hypothesize that the direction of asymmetry in dopamine (DA) depletion predicts the asymmetry in visual attention. Objectives: Primary Objective: \- to study attentional asymmetry in patients with PD. We hypothesize that visual attention in Parkinson will be biased to the visual field contralateral to the least affected hemisphere (i.e. contralateral to the most affected side). Secondary Objectives: * to investigate the correlation between feedback learning and visuospatial attention performance in PD. We hypothesize that feedback learning will also be affected according to the most compromised hemisphere. Right hemisphere-predominant PD patients (left-motor predominant), compared to left hemisphere-predominant patients, will exhibit a rightward visuospatial bias and a relative preference for learning from reward, compared to punishment. * to investigate the effect of prism adaptation on feedback learning and visuospatial attention in PD. This objective is exploratory. Endpoints: Primary Endpoint: visuospatial performance on the Landmark Task Secondary Endpoints: performance on: * Posner Task * Visual Search Task * Attentional blink Task * Visuospatial performance on the Manual Line Bisection Task * Reward and Punishment Implicit Feedback Learning Task * The Attentional Scaling Task Functional connectivity measured with resting state fMRI. Study Population: Sixty patients with asymmetric PD. Any gender, aged 35-80 (inclusive), able to give consent and without a diagnosis of significant illness affecting the central nervous system other than PD.

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