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.2016 Jul;234(7):1837-1848.
doi: 10.1007/s00221-016-4577-9. Epub 2016 Feb 18.

Subthalamic nucleus deep brain stimulation induces impulsive action when patients with Parkinson's disease act under speed pressure

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Subthalamic nucleus deep brain stimulation induces impulsive action when patients with Parkinson's disease act under speed pressure

Inês Pote et al. Exp Brain Res.2016 Jul.

Abstract

The subthalamic nucleus (STN) is proposed to modulate response thresholds and speed-accuracy trade-offs. In situations of conflict, the STN is considered to raise response thresholds, allowing time for the accumulation of information to occur before a response is selected. Conversely, speed pressure is thought to reduce the activity of the STN and lower response thresholds, resulting in fast, errorful responses. In Parkinson's disease (PD), subthalamic nucleus deep brain stimulation (STN-DBS) reduces the activity of the nucleus and improves motor symptoms. We predicted that the combined effects of STN stimulation and speed pressure would lower STN activity and lead to fast, errorful responses, hence resulting in impulsive action. We used the motion discrimination 'moving-dots' task to assess speed-accuracy trade-offs, under both speed and accuracy instructions. We assessed 12 patients with PD and bilateral STN-DBS and 12 age-matched healthy controls. Participants completed the task twice, and the patients completed it once with STN-DBS on and once with STN-DBS off, with order counterbalanced. We found that STN stimulation was associated with significantly faster reaction times but more errors under speed instructions. Application of the drift diffusion model showed that stimulation resulted in lower response thresholds when acting under speed pressure. These findings support the involvement of the STN in the modulation of speed-accuracy trade-offs and establish for the first time that speed pressure alone, even in the absence of conflict, can result in STN stimulation inducing impulsive action in PD.

Keywords: Deep brain stimulation; Impulsivity; Parkinson’s disease; Response threshold; Speed–accuracy trade-off; Subthalamic nucleus.

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Figures

Fig. 1
Fig. 1
Sequence of stimulus and feedback presentation on the screen for the moving-dots task during:a the accuracy trials andb the speed trials
Fig. 2
Fig. 2
Mean RT (ms) as a function of STN-DBS on or off for patients with Parkinson’s disease, and Time of assessment (Time 1 = first, Time 2 = second assessment) for the healthy controls;asterisk denotes significant differences
Fig. 3
Fig. 3
Mean RT (ms) fora patients with Parkinson’s disease with STN-DBS on or off andb healthy controls for Time 1 (first) and Time 2 (second) assessments, under both speed and accuracy instructions;asterisk denotes significant differences
Fig. 4
Fig. 4
Mean percentage error (PE%)a for patients with Parkinson’s disease and healthy controls, under speed versus accuracy instructions, andb as a function of STN-DBS/Time, under speed versus accuracy instructions;asterisk denotes significant differences
Fig. 5
Fig. 5
Mean response thresholds fora patients with Parkinson’s disease with STN-DBS on or off (DBS on, DBS off), andb healthy controls at the two assessments (Time 1 = first, Time 2 = second), under speed versus accuracy instructions
Fig. 6
Fig. 6
Mean non-decision time for patients with Parkinson’s disease with deep brain stimulation on versus off (DBS on, DBS off) and healthy controls for the Time 1 versus Time 2 assessments (Time 1 = first, Time 2 = second);asterisk denotes significant differences
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