Fuhrer et al., Levodopa in habit learning. Supp., J Neural Transm.,2013
Methods
Supplemental figure 1: Experimental design of WPT
Supplemental Figure 1: Experimental design of the Weather Prediction Task (WPT). Participants were asked to predict the weather (outcome: “sun” or “rain”) based on four different visual cues across 3 sessions of 50 trials each. The cues consisted of four different geometrical forms visually presented on a computer screen. On each session each of the 4 cards was related to the outcome sunshine with a probability of 21, 39, 61, or 79% and to the outcome rain with a probability of 79, 61, 39, or 21%, respectively. Probabilities were redistributed after each session. Sessions were separated by breaks of 1 minute. In order to depict an anticipated gradual learning curve for correct answers each session of the 50 WPT trials was divided into 5 blocs; thus, 10 trials are one bloc (as exemplified for bloc 1 in the figure), resulting into 5 blocs for all subjects per session (trials 1-10=bloc1, 11-20=bloc2, 21-30=bloc3, 31-40=bloc4, 41-50=bloc5).
All participants completed further tests assessing verbal long term and working memory via parallel versions of Rey Auditory Verbal Learning Test (RAVLT) (Lezak 1995) and Digit Ordering Test (DOT) (Werheid et al. 2002), affective state via Beck’s Anxiety Index (BAI), Snaith-Hamilton-Anhedony-Pleasure-Scale (SHAPS), Brief Symptom Inventory (BSI) (Lezak 1995) and a German equivalent of the Multidimensional Mood State Questionnaire (MDMQ) (Steyer 1997). Controls performed only one set of trials.
Results
Verbal memory testing via the RAVLT did not differ between PD-OFF, -ON and controls (cf. supplemental table). Following levodopa intake working memory assessed by DOT was significantly ameliorated in PD ON-patients compared to their OFF-state (p=0.036, t(19)=2.263), and PD-patients did not show any difference compared to control group (cf. supplemental table). Overall mood state in PD-patients measured by BSI, BAI, MDMQ, both ON and OFF, was significantly worse compared to the control group. No differences between ON vs. OFF vs. controls were observed in anhedonia assessed by SHAPS.
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Fuhrer et al., Levodopa in habit learning. Supp., J Neural Transm.,2013
Supplemental table 1: Results of further cognitive and affective testing comparing PD OFF, PD ON and controls
variable / PD OFFM (SD) / PD ON
M (SD) / controls
M (SD) / significance p
(OFF vs. controls) / significance p
(ON vs. controls) / significance p
(OFF vs. ON)
RAVLT
DOT
BAI
SHAPS
BSI
- global severity index
- somatization
- Obsession-Compulsion
- Interpersonal Sensitivity
- Depression
- Anxiety
- Hostility
- Phobic anxiety
- Paranoid ideation
- Psychoticism
- Additional Items
MDMQ / 18.05 (4.56)
5.55 (1.67)
18.05 (4.56)
5.50 (1,67)
18.80 (9.06)
5.70 (3.96)
5.40 (4.16)
2.05 (2.64)
3.05 (3.98)
5.10 (3.82)
1.75 (2.24)
2.70 (3.05)
1.65 (2.91)
1.90 (2.92)
3.45 (3.85)
1.00 (1.86) / 17.85 (4.54)
6.50 (2.01)
14.05 (8.94)
.55 (0.83)
22.90 (18.30)
4.15 (3.18)
4.40 (4.22)
1.45 (2.09)
1.60 (2.39)
3.70 (2.70)
1.10 (1.74)
2.45 (2.21)
1.35 (2.18)
1.05 (1.67)
1.65 (1.50)
89.95 (17.10) / 18.35 (3.88)
5.50 (1.70)
4.80 (4.82)
0.20 (0.41)
10.25 (9.12)
1.20 (1.61)
2.45 (1.82)
.90 (1.12)
.75 (1.29)
.65 (.99)
.70 (.92)
.35 (.67)
1.40 (1.93)
.90 (1.21)
.95 (1.19)
109.30 (11.93) / .824 (t(38)=-.224)
.926 (t(38)=.094)
.000 (Z= -4.814)
.136 (Z= -1.379)
.001 (Z= -3.357)
.000 (Z= -3.930)
.020 (Z= -2.319)
.173 (Z= -1.364)
.010 (Z= -2.579)
.000 (Z= -4.275)
.284 (Z= -1.072)
.000 (Z= -3.702)
.730 (Z= -.346)
.304 (Z= -1.028)
.002 (Z= -3.043)
.000 (Z= -4.805) / .710 (t(38)=-.374)
.098 (t(38)=1.697)
.000 (Z= -3.717)
.137 (Z= -1.486)
.015 (Z= -2.438)
.011 (Z= -3.369)
.262 (Z= -1.121)
.628 (Z= -.485)
.165 (Z= -1.390)
.000 (Z= -4.390)
.788 (Z= -.269)
.001 (Z= -3.405)
.919 (Z= -.102)
.916 (Z= -.106)
.120 (Z= -1.555)
.000 (Z= -3.614) / .803 (t(19)=-.253)
.036 (t(19)=2.263)
.029 (Z= -2.185)
.292 (Z= -1.054)
.018 (Z= -2.375)
.045 (Z= -1.845)
.131 (Z= -1.511)
.159 (Z= -1.410)
.004 (Z= 2.848)
.068 (Z= -1.827)
.103 (Z= -1.628)
.751 (Z= .317)
.470 (Z= -.723)
.081 (Z= -1.747)
.011 (Z= -2.540)
.004 (Z= 2.875)
M (SD): means and standard deviations of PD-patients and controls; independent sample student-t-test and Wilcoxon-test; two-tailed, significance level p<.05. BAI: Beck’s Anxiety Inventory; SHAPS: Snaith-Hamilton-Anhedony-Pleasure-Scale; BSI: Brief Symptom Inventory; MDMQ: Multidimensional Mood State Questionnaire
Supplemental table 2: Individual learning data of non-declarative Weather Prediction Task comparing OFF- versus ON-state in each bloc, bloc 4 versus bloc 1 during ON- and OFF- state, respectively. Deteriorations of ≥1 standard deviation (SD; ↓), ≥ 2 SD (↓↓), improvements of ≥1SD (↑), ≥ 2 SD (↑↑), no changes within range of ≤1 SD (=)
Patient No. / 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 11 / 12 / 13 / 14 / 15 / 16 / 17 / 18 / 19 / 20bloc 4 vs. 1
ON
OFF / ↓
↑ / =
↑ / ↑↑
↑ / ↑↑
↑ / =
= / ↓
↑ / =
= / =
↑↑ / =
↓ / =
= / =
= / ↑
= / =
↑ / =
↑↑ / =
↑ / =
= / =
↑ / ↑
↑ / ↓
= / =
=
Supplemental table 2 shows that 11 PD-patients in the OFF-state improved in bloc 4 versus bloc 1, 1 worsened, and 8 PD-patients did not change >1 SD).In contrast in the ON-state only 4 PD-patients improved, 3 worsened, and 13 did not change.
References
Lezak M (1995) Neuropsychological Assessment. New York: Oxford University Press
Steyer R, Schwenkmezger, P., Notz, P. und Eid, M. (1997) Der Mehrdimensionale Befindlichkeitsfragebogen (MDBF). Göttingen: Hogrefe,
Werheid K, Hoppe C, Thone A, Muller U, Mungersdorf M, von Cramon DY (2002) The Adaptive Digit Ordering Test: clinical application, reliability, and validity of a verbal working memory test. Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists 17 (6):547-565
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