{
  "abstract": "Background: Common side effects of dopamine replacement therapy (DRT) for Parkinson's Disease (PD) are addiction-like impulse control disorders, including compulsive gambling. Gambling products such as slot machines prominently feature reward-paired audiovisual stimuli, which can promote riskier choices on laboratory gambling tasks in both humans and rodents. In rats, risky decision making in the presence of reward-paired cues is dependent on dopamine D3 receptor activity and is increased by ropinirole, a D2/3 receptor agonist with a higher affinity for D3 receptors. In humans, it remains uncertain whether cue-induced risky choice is amplified by dopamine agonism. Methods: We tested effects of DRT on cue-induced risky choice in 62 patients with PD (34 on levodopa monotherapy, 27 on levodopa and dopamine agonists). Patients performed two versions of a risky decision-making task: one with and one without reward-paired sensory cues, both ON and OFF DRT. A group of 36 age-matched controls completed the same task versions without DRT. Results: Across all groups, participants made riskier choices when the task included reward-paired sensory cues. Levodopa monotherapy did not affect risky decision-making. However, a combination of levodopa and dopamine agonists increased risky choices specifically in the uncued version of the task, making performance indistinguishable from that on the cued task. Conclusions: Dopamine agonists combined with levodopa promote risk-taking even in the absence of reward-paired cues. This could translate into risky reward-seeking behaviors that are decoupled from contextual factors.",
  "abstract_shown": true,
  "affiliations": [
    "West Virginia University"
  ],
  "article_type": "New results",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "name": "K. Muksuris"
    },
    {
      "name": "E. Flynn"
    },
    {
      "name": "T. L. Feng"
    },
    {
      "name": "P. Surathi"
    },
    {
      "name": "S. C. Yeung"
    },
    {
      "name": "L. Mortazavi"
    },
    {
      "name": "A. Isberg"
    },
    {
      "name": "M. McKeown"
    },
    {
      "name": "S. Appel-Cresswell"
    },
    {
      "name": "C. A. Winstanley"
    },
    {
      "name": "A. J. Stoessl"
    },
    {
      "name": "J. Barton"
    },
    {
      "affs": [
        0
      ],
      "name": "M. V. Cherkasova"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1943tna7w3vbx.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.05.748022",
  "fulltext_url": "https://www.biorxiv.org/content/10.64898/2026.09.05.748022v1.full",
  "id": "1943tna7w3vbx",
  "issns": [],
  "landing_url": "https://www.biorxiv.org/content/10.64898/2026.09.05.748022v1",
  "language": null,
  "licence": "CC-BY-ND",
  "licence_label": "CC BY-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "biorxiv",
      "neuroscience"
    ],
    [
      "openalex",
      "2728|Parkinson's Disease Mechanisms and Treatments"
    ]
  ],
  "openalex": "W7212440108",
  "pdf_url": "https://www.biorxiv.org/content/10.64898/2026.09.05.748022v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-05",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1943tna7w3vbx.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:47Z",
      "native_id": "10.64898/2026.09.05.748022",
      "source": "biorxiv",
      "url": "https://www.biorxiv.org/content/10.64898/2026.09.05.748022v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "biorxiv:neuroscience",
      "subfield": "neuroscience"
    }
  ],
  "title": "Dopamine Agonists in Parkinson's Disease Decouple Risk-Taking from Reward-Paired Cues by Enhancing Risky Choice in Their Absence",
  "title_text": "Dopamine Agonists in Parkinson's Disease Decouple Risk-Taking from Reward-Paired Cues by Enhancing Risky Choice in Their Absence",
  "type": "preprint",
  "updated_at": "2026-10-30T12:21:47Z",
  "url": "https://research.draconitic.com/paper/1943tna7w3vbx",
  "venue": "bioRxiv",
  "versions": []
}