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To address this issue, we examined the effects of dopamine-related medications in a subliminal instrumental learning paradigm. To assess generality of dopamine implication, we tested both dopamine enhancers in Parkinson's disease (PD) and dopamine blockers in Tourette's syndrome (TS). During the task, patients had to learn from monetary outcomes the expected value of a risky choice. The different outcomes (rewards and punishments) were announced by visual cues, which were masked such that patients could not consciously perceive them. Boosting dopamine transmission in PD patients improved reward learning but worsened punishment avoidance. Conversely, blocking dopamine transmission in TS patients favored punishment avoidance but impaired reward seeking. These results thus extend previous findings in PD to subliminal situations and to another pathological condition, TS. More generally, they suggest that pharmacological manipulation of dopamine transmission can subconsciously drive us to either get more rewards or avoid more punishments.<\/jats:p>","DOI":"10.1073\/pnas.0904035106","type":"journal-article","created":{"date-parts":[[2009,10,22]],"date-time":"2009-10-22T22:06:21Z","timestamp":1256249181000},"page":"19179-19184","update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":147,"title":["Pharmacological modulation of subliminal learning in Parkinson's and Tourette's syndromes"],"prefix":"10.1073","volume":"106","author":[{"given":"Stefano","family":"Palminteri","sequence":"first","affiliation":[{"name":"Institut du Cerveau et de la Mo\u00eblle \u00e8pini\u00e8re (CR-ICM), F-75013 Paris, France;"},{"name":"Institut de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), Unit\u00e9 Mixte de Recherche (UMR 975), F-75013 Paris, France;"},{"name":"Universit\u00e9 Pierre et Marie Curie (UPMC-Paris 6), F-75013 Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u00ebl","family":"Lebreton","sequence":"additional","affiliation":[{"name":"Institut du Cerveau et de la Mo\u00eblle \u00e8pini\u00e8re (CR-ICM), F-75013 Paris, France;"},{"name":"Institut de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), Unit\u00e9 Mixte de Recherche (UMR 975), F-75013 Paris, France;"},{"name":"Universit\u00e9 Pierre et Marie Curie (UPMC-Paris 6), F-75013 Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulia","family":"Worbe","sequence":"additional","affiliation":[{"name":"Institut du Cerveau et de la Mo\u00eblle \u00e8pini\u00e8re (CR-ICM), F-75013 Paris, France;"},{"name":"Institut de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), Unit\u00e9 Mixte de Recherche (UMR 975), F-75013 Paris, France;"},{"name":"Universit\u00e9 Pierre et Marie Curie (UPMC-Paris 6), F-75013 Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Grabli","sequence":"additional","affiliation":[{"name":"Institut du Cerveau et de la Mo\u00eblle \u00e8pini\u00e8re (CR-ICM), F-75013 Paris, France;"},{"name":"Institut de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), Unit\u00e9 Mixte de Recherche (UMR 975), F-75013 Paris, France;"},{"name":"Universit\u00e9 Pierre et Marie Curie (UPMC-Paris 6), F-75013 Paris, France;"},{"name":"F\u00e9d\u00e9ration de Neurologie, Groupe Hospitalier Piti\u00e9-Salp\u00eatri\u00e8re, Assistance Publique-H\u00f4pitaux de Paris, F-75013 France; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Institut du Cerveau et de la Mo\u00eblle \u00e8pini\u00e8re (CR-ICM), F-75013 Paris, France;"},{"name":"Institut de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), Unit\u00e9 Mixte de Recherche (UMR 975), F-75013 Paris, France;"},{"name":"Universit\u00e9 Pierre et Marie Curie (UPMC-Paris 6), F-75013 Paris, France;"},{"name":"Centre de R\u00e9f\u00e9rence \u201cSyndrome Gilles de la Tourette\u201d, F-75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Pessiglione","sequence":"additional","affiliation":[{"name":"Institut du Cerveau et de la Mo\u00eblle \u00e8pini\u00e8re (CR-ICM), F-75013 Paris, France;"},{"name":"Institut de la Sant\u00e9 et de la Recherche M\u00e9dicale (INSERM), Unit\u00e9 Mixte de Recherche (UMR 975), F-75013 Paris, France;"},{"name":"Universit\u00e9 Pierre et Marie Curie (UPMC-Paris 6), F-75013 Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"341","published-online":{"date-parts":[[2009,11,10]]},"reference":[{"key":"e_1_3_3_1_2","first-page":"64","volume-title":"Classical Conditioning II: Current Research and Theory","author":"Rescorla RA","year":"1972","unstructured":"RA Rescorla, AR Wagner, A theory of Pavlovian conditioning: Variations in the effectiveness of reinforcement and nonreinforcement. 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