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Preliminary evidence of discourse improvement with dopaminergic medication

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DOI: 10.4236/apd.2013.22007    3,212 Downloads   5,398 Views   Citations


Dopaminergic therapy can improve motor functioning in Parkinson’s disease (PD), but its effect on spoken discourse is poorly understood. This study addressed whether discourse produced during a one-minute monologue would be affected by medication withdrawal. We performed a detailed analysis of semistructured speech samples in 38 patients with PD, including measures of efficiency, syntactic complexity, cohesion (i.e., lexical and grammatical ties between sentences), and coherence (i.e., semantic relationship between the utterances and the topic, or between utterances). We found that patients produced more efficient and coherent monlogues when on versus off medication. As discourse relies heavily on cognitive processes such as working memory, these findings are consistent with research showing improved working memory and executive processes with dopaminegic medication.

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The authors declare no conflicts of interest.

Cite this paper

Sanchez, J. and Spencer, K. (2013) Preliminary evidence of discourse improvement with dopaminergic medication. Advances in Parkinson's Disease, 2, 37-42. doi: 10.4236/apd.2013.22007.


[1] Farag, C., Troini, V., Bonner, M., Powers, C., Avants, B., Gee, J., et al. (2010) Hierarchical organization of scripts: Converging evidence from fMRI and frontotemporal dementia. Cerebral Cortex, 20, 2453-2463. doi:10.1093/cercor/bhp313
[2] Crescentini, C., Mondolo, F., Biasutti, E. and Shallice T. (2008) Supervisory and routine processes in noun and verb generation in nondemented patients with Parkinson’s disease. Neuropsychologia, 46, 434-447. doi:10.1016/j.neuropsychologia.2007.08.021
[3] Monetta, L., Grindrod, C. M. and Pell, M. D. (2008) Effects of working memory capacity on inference generation during story comprehension in adults with Parkinsons disease. Journal of Neurolinguistics, 21, 400-417. doi:10.1016/j.jneuroling.2007.11.002
[4] McNamara, P. and Durso, R. (2003) Pragmatic communication skills in patients with Parkinson’s disease. Brain and Language, 84, 414-423. doi:10.1016/S0093-934X(02)00558-8
[5] Murray, L.L. (2000) Spoken language production in Huntington’s and Parkinson’s diseases. Journal of Speech, Language, and Hearing Research, 43, 1350-1366.
[6] Portin, R., Laatu, S., Revonsuo, A. and Rinne, U.K. (2000) Impairment of semantic knowledge in Parkinson disease. Archives of Neurology, 57, 1338-1343. doi:10.1001/archneur.57.9.1338
[7] Ash, S., McMillan, C., Gross, R.G., Cook, P., Morgan, B., Boller, A., Dreyfuss, M., Siderowf, A. and Grossman, M. (2011) The organization of narrative discourse in Lewy body spectrum disorder. Brain & Language, 199, 30-41. doi:10.1016/j.bandl.2011.05.006
[8] Cools, R. (2006) Dopaminergic modulation of cognitive function-implications for L-DOPA treatment in Parkinson’s disease. Neuroscience and Biobehavioral Reviews, 30, 1-23. doi:10.1016/j.neubiorev.2005.03.024
[9] Zgaljardic, D.J., Borod, J.C., Foldi, N.S., Mattis, P.J., Gordon, M.F., Feigin, A., et al. (2006) An examination of executive dysfunction associated with frontostriatal circuitry in Parkinson’s disease. Journal of Clinical and Experimental Neuropsychology, 28, 1127-1144. doi:10.1080/13803390500246910
[10] Youse, K.M. and Coelho, C.A. (2005) Working memory and discourse production abilities following closed-head injury. Brain Injury, 19, 1001-1009. doi:10.1080/02699050500109951
[11] Murray, L.L. and Stout, J.C. (1999) Discourse comprehension in Huntington’s and Parkinson’s diseases. American Journal of Speech Language Pathology, 8, 137-148.
[12] Crucian, G.P., Huang, L., Barrett, A.M., Schwartz, R.L., Cibula, J.E., Anderson, J.M., et al. (2001) Emotional conversations in Parkinson’s disease. Neurology, 56, 159-165. doi:10.1212/WNL.56.2.159
[13] Hoehn, M.M. and Yahr, M.D. (1967) Parkinsonism: Onset, progression and mortality. Neurology, 17, 427-442. doi:10.1212/WNL.17.5.427
[14] Folstein, M., Folstein, S. and McHugh, P. (1975) Minimental state: A practical method for grading the cognitive state of patients for the clinician. Journal Psychiatric Research, 12, 189-198. doi:10.1016/0022-3956(75)90026-6
[15] Beck, A.T., Steer, R.G. and Brown, G.K. (1996) Beck depression inventory. The Psychological Corporation, San Antonio.
[16] Goodglass, H. and Kaplan, E. (1976) The assessment of aphasia and related disorders. Lea & Febiger, Philadelphia.
[17] Kay, J., Lesser, R. and Coltheart, M. (1992) Psycholinguistic assessment of language processing in Aphasia. Lawrence Erlbaum, Hove.
[18] Defer, G.L., Widner, H., Marie, R.M., Remy, P. and Levivier, M. (1999) Core assessment program for surgical intervention therapies in Parkinson’s disease (CAPSITPD). Movement Disorders, 14, 572-584. doi:10.1002/1531-8257(199907)14:4<572::AID-MDS1005>3.0.CO;2-C
[19] Miller J. and Chapman, R. (1985) Systematic analysis of language transcripts: User’s manual. University of Wisconsin, Madison.
[20] Glosser, G., Wiener, M. and Kaplan, E. (1988) Variations in aphasic language behavior. Journal of Speech & Hearing Disorders, 53, 115-124.
[21] Halliday, M.A.K. and Hasan, R. (1976) Cohesion in English. Longman, London.
[22] Van Leer, E. and Turkstra, L. (1999) The Effect of Elicitation task on discourse coherence and cohesion in adolescents with brain injury. Journal of Communication Disorders, 32, 327-49. doi:10.1016/S0021-9924(99)00008-8
[23] MacDonald, P.A., MacDonald, A.A., Seergobin, K.N., Tamjeddi, R., Ganjavi, H., Provost, J.-S. and Monchi, O. (2011) The effect of dopamine replacement therapy on ventral dorsal striatum-mediated cognition in Parkinson’s disease: Support from functional MRI. Brain, 134, 1447-1463. doi:10.1093/brain/awr075
[24] Torta, D.M.E., Castelli, L., Zibetti, M., Lopiano, L. and Geminiani, G. (2009) On the role of dopamine replacement therapy in decision-making, working memory, and reward in Parkinson’s disease: Does therapy dose matter? Brain and Cognition, 71, 84-91. doi:10.1016/j.bandc.2009.04.003
[25] Murray L.L. and Lenz L.P. (2001) Productive syntax abilities in Huntington’s and Parkinson’s diseases. Brain and Cognition, 46, 213-219. doi:10.1016/S0278-2626(01)80069-5
[26] Illes J., Metter E.J., Hanson W.R. and Iritani S. (1988) Language production in Parkinson’s disease: Acoustic and linguistic considerations. Brain and Language, 33, 146-160. doi:10.1016/0093-934X(88)90059-4
[27] De Letter, M., Santens, P., De Bodt, M., Boon, P. and Van Borsel, J. (2006) Levodopa-induced alterations in speech rate in advanced Parkinson’s disease. Acta Neurologica Belgica, 106, 19-22.
[28] De Letter, M., Santens, P., Estercam, I., Van Maele, G., De Bodt, M., Boon, P. and Van Borsel, J. (2007) Levodopa-induced modifications of prosody and comprehensibility in advanced Parkinson’s disease as perceived by professional listeners. Clinical Linguistics & Phonetics, 21, 783-791. doi:10.1080/02699200701538181
[29] Goberman, A., Coelho, C. and Robb, M. (2005) Prosodic characteristics of Parkinsonian speech: The effect of Levodopa-based medication. Journal of Medical Speech-Language Pathology, 13, 51-68.
[30] Cropley, V.L., Fujita, M., Innis, R.B. and Nathan P.J. (2006) Molecular imaging of the dopaminergic system and its association with human cognitive function. Biological Psychiatry, 59, 898-907. doi:10.1016/j.biopsych.2006.03.004
[31] Fera, F., Nicoletti, G., Cerasa, A., et al., (2007) Dopaminergic modulation of cognitive interference after pharmacological washout in Parkinson’s disease. Brain Research Bulletin, 74, 75-83. doi:10.1016/j.brainresbull.2007.05.009
[32] Cools, R., Stefanova, E., Barker, R.A., Robbins, T.W. and Owen, A.M. (2002) Dopaminergic modulation of highlevel cognition in Parkinson’s disease: The role of the prefrontal cortex revealed by PET. Brain, 125, 584-594. doi:10.1093/brain/awf052
[33] Lewis, S.J., Dove, A., Robbins, T.W., Barker, R.A. and Owen, A.M. (2003) Cognitive impairments in early Parkinson’s disease are accompanied by reductions in activity in frontostriatal neural circuitry. The Journal of Neuroscience: The Official Journal of the Society for Neuroscience, 23, 6351-6356.
[34] Lange, K.W., Robbins, T.W., Marsden, C.D., James, M., Owen, A.M. and Paul, G.M. (1992) L-dopa withdrawal in Parkinson’s disease selectively impairs cognitive performance in tests sensitive to frontal lobe dysfunction. Psychopharmacology, 107, 394-404. doi:10.1007/BF02245167
[35] Lewis, S.J., Slabosz, A., Robbins, T.W., Barker, R.A. and Owen A.M. (2005) Dopaminergic basis for deficits in working memory but not attentional set-shifting in Parkinson’s disease. Neuropsychologia, 43, 823-832. doi:10.1016/j.neuropsychologia.2004.10.001
[36] Moustafa, A.A, Sherman, S.J. and Frank, M.J. (2008) A dopaminergic basis for working memory, learning and attentional shifting in Parkinsonism. Neuropsychologia, 46, 3144-3156. doi:10.1016/j.neuropsychologia.2008.07.011
[37] Brookshire, B., Chapman, S., Song, J. and Levin, H. (2000) Cognitive and linguistic correlates of children’s discourse after closed head injury: A three-year follow-up. Journal of the International Neuropsychological Society, 6, 741-751. doi:10.1017/S1355617700677019

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