Alterations in Response Switching in Parkinson's Disease: New Insights Into Cueing.

Abstract

Switching, a critical executive function, can manifest as task switching (TS) or response switching (RS). Although TS impairments in Parkinson's disease (PD) are well-studied, RS, especially in contexts requiring adaptive behavior to external or internal cues, is less explored. This study evaluated the impact of PD on RS under exogenous and endogenous cueing. Using a gamified, remote task triggering these cues, RS was assessed in 85 PD patients and 82 neurologically healthy participants (NHP). RS cost was quantified by comparing reaction times between repeating and changing responses. A linear mixed model analyzed the effects of group, cueing mode, and their interaction on RS cost. PD patients exhibited increased RS costs under exogenous cueing but not under endogenous cueing. These findings indicate that while PD patients can effectively use predictive endogenous cues, they struggle with less predictive exogenous cues, emphasizing the need for compensatory strategies and technological aids in daily activities.