Background and objectives <p>The impact of dopaminergic medication on language in Parkinson’s disease (PD) remains poorly understood. This observational, naturalistic study aimed to investigate the effects of long-term dopaminergic therapy on language performance in patients with de-novo PD based on a high-level linguistic analysis of natural spontaneous discourse.</p> Methods <p>A fairy-tale narration was recorded at baseline and a 12-month follow-up. The speech samples were automatically analyzed using six representative lexical and syntactic features based on automatic speech recognition and natural language processing.</p> Results <p>We enrolled 109 de-novo PD patients compared to 68 healthy controls. All subjects completed the 12-month follow-up; 92 PD patients were on stable dopaminergic medication (PD-treated), while 17 PD patients remained without medication (PD-untreated). At baseline, the PD-treated group exhibited abnormalities in syntactic domains, particularly in sentence length (<i>p</i> = 0.018) and sentence development (<i>p</i> = 0.042) compared to healthy controls. After 12 months of dopaminergic therapy, PD-treated showed improvements in the syntactic domain, including sentence length (<i>p</i> = 0.012) and sentence development <i>(p</i> = 0.030). Of all PD-treated patients, 37 were on monotherapy with dopamine agonists and manifested improvement in sentence length (<i>p</i> = 0.048), while 32 were on monotherapy with levodopa and had no language amelioration. No changes in language parameters over time were seen in both the PD-untreated group and healthy controls.</p> Discussion <p>Initiation of dopaminergic therapy improved high-language syntactic deficits in de-novo PD, confirming the role of dopamine in cognitive-linguistic processing. Automated linguistic analysis of spontaneous speech via natural language processing can assist in improving the prediction and management of language deficits in PD.</p>