The Effect of Dopaminergic Replacement Therapy on Creative Thinking and Insight Problem-Solving in Parkinson's Disease Patients

Abstract

Parkinson's disease (PD) patients receiving dopaminergic treatment may experience bursts of creativity. Although this phenomenon is sometimes recognized among patients and their clinicians, the association between dopamine replacement therapy (DRT) in PD patients and creativity remains underexplored. It is unclear, for instance, whether DRT affects creativity through convergent or divergent thinking, idea generation, or a general lack of inhibition. It is also unclear whether DRT only augments pre-existing creative attributes or generates creativity de novo. Here, we tested a group of PD patients when “on” and “off” dopaminergic treatment on a series of tests of creative problem-solving (Alternative Uses Task, Compound Remote Associates, Rebus Puzzles), and related their performance to a group of matched healthy controls as well as to their pre-PD creative skills and measures of inhibition/impulsivity. Results did not provide strong evidence that DRT improved creative thinking in PD patients. Rather, PD patients “on” medication showed less flexibility in divergent thinking, generated fewer ideas via insight, and showed worse performance in convergent thinking overall (by making more errors) than healthy controls. Pre-PD creative skills predicted enhanced flexibility and fluency in divergent thinking when PD patients were “on” medication. However, results on convergent thinking were mixed. Finally, PD patients who exhibited deficits in a measure of inhibitory control showed weaker convergent thinking while “on” medication, supporting previous evidence on the importance of inhibitory control in creative problem-solving. Altogether, results do not support the hypothesis that DRT promotes creative thinking in PD. We speculate that bursts of artistic production in PD are perhaps conflated with creativity due to lay conceptions of creativity (i.e., an art-bias).

Solving problems with an Aha! increases risk preference

“…Incidental positive emotions have been found to increase uncertainty tolerance among participants (Jiang et al, 2009;Zhao, Gu et al, 2016), consistent with our results. Additionally, insight is putatively associated with neural reward signals, according to neuroimaging research (Ludmer et al, 2011;Oh et al, 2020;Salvi et al, 2021;Subramaniam et al, 2008;Tik et al, 2018). A reward signal in the brain may increase people's sensitivity to positive outcomes.…”

Markers of Insight

“…Eighty-two percent of lateral frontal patients solved the most difficult problems compared to healthy control participants who solved only 43% of the same kind of problems. By contrast, patients affected by Parkinson's disease, a degenerative disorder characterized by the loss of dopamine neurons in the bilateral nigrostriatal pathway, are impaired specifically when solving problems via insight but not via analysis (Salvi et al, 2021). This study advanced the idea of a specific dopamine pathway to be more important for insights, but also that an impairment in this pathway may lead to a shift to an analytical strategy which, since it does not involve dopamine functioning, may remain unaltered by the disease state.…”

“…While this explanation needs further corroboration, hopefully with studies on animals and children, it is in line with recent literature theorizing the adaptive function of the Aha! feeling as a signal to more accurate ideas that are processed below awareness (Salvi et al 2021;Laukkonen et al, 2020). Since scientists cannot measure 'Aha!'…”

Does social rigidity predict cognitive rigidity? Profiles of socio-cognitive polarization

“…Problem-solving is considered an expression of cognitive flexibility, which translates into the ability to generate novel and original ideas by exploring unusual reasoning paths and challenging rigid perspectives around us (De Dreu et al, 2008 ; De Dreu et al, 2008 ; Perry-Smith & Mannucci, 2017 ). While problem-solving has been shown to positively predict the ability to discern veridical from false or misleading information, cognitive attributes including bullshit receptivity (i.e., the tendency to believe in pseudo-profound statements) and overclaiming (i.e., the tendency to claim to know something that actually does not exist) have been demonstrated to predict lower discernment of misinformation (e.g., Pennycook et al, 2020 ; Salvi et al, 2021a , b , 2022 ).…”

“…We recently proposed the construct of socio-cognitive polarization (SCP), which includes conservative political ideology, absolutism/intolerance of ambiguity, and xenophobia, to capture dimensions that share features of social and cognitive rigidity that go beyond just pure political beliefs (Salvi et al, 2021a , b ). The shared literature on emotional, social, and cognitive factors underlying SCP suggests that people who score higher in these social measures may be less likely to handle complexity (such as understanding vaccination efficacy; Cancer et al, 2023a , b ) and thus fail to seek out alternative explanations when processing especially novel information (Salvi et al, 2016a , b , c , 2021a , b ; Rollwage, Zmigrod et al, 2019 ; Zmigrod et al, 2018 , 2019 ). Therefore, people higher in SCP may be more prone to rate pseudo-profound bullshit statements as profound, and to their overclaim knowledge about fake historical events.…”