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Branam K, Gold JI, Ding L. The subthalamic nucleus contributes causally to perceptual decision-making in monkeys. eLife 2024; 13:RP98345. [PMID: 39311685 PMCID: PMC11419670 DOI: 10.7554/elife.98345] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2024] Open
Abstract
The subthalamic nucleus (STN) plays critical roles in the motor and cognitive function of the basal ganglia (BG), but the exact nature of these roles is not fully understood, especially in the context of decision-making based on uncertain evidence. Guided by theoretical predictions of specific STN contributions, we used single-unit recording and electrical microstimulation in the STN of healthy monkeys to assess its causal, computational roles in visual-saccadic decisions based on noisy evidence. The recordings identified subpopulations of STN neurons with distinct task-related activity patterns that related to different theoretically predicted functions. Microstimulation caused changes in behavioral choices and response times that reflected multiple contributions to an 'accumulate-to-bound'-like decision process, including modulation of decision bounds and evidence accumulation, and to non-perceptual processes. These results provide new insights into the multiple ways that the STN can support higher brain function.
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Affiliation(s)
- Kathryn Branam
- Department of Neuroscience, University of PennsylvaniaPhiladelphiaUnited States
| | - Joshua I Gold
- Department of Neuroscience, University of PennsylvaniaPhiladelphiaUnited States
| | - Long Ding
- Department of Neuroscience, University of PennsylvaniaPhiladelphiaUnited States
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2
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Rogers K, Gold JI, Ding L. The subthalamic nucleus contributes causally to perceptual decision-making in monkeys. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.09.588715. [PMID: 38645039 PMCID: PMC11030388 DOI: 10.1101/2024.04.09.588715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
The subthalamic nucleus (STN) plays critical roles in the motor and cognitive function of the basal ganglia (BG), but the exact nature of these roles is not fully understood, especially in the context of decision-making based on uncertain evidence. Guided by theoretical predictions of specific STN contributions, we used single-unit recording and electrical microstimulation in the STN of healthy monkeys to assess its causal, computational roles in visual-saccadic decisions based on noisy evidence. The recordings identified subpopulations of STN neurons with distinct task-related activity patterns that related to different theoretically predicted functions. Microstimulation caused changes in behavioral choices and response times that reflected multiple contributions to an "accumulate-to-bound"-like decision process, including modulation of decision bounds and evidence accumulation, and to non-perceptual processes. These results provide new insights into the multiple ways that the STN can support higher brain function.
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3
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Voon V, Manssuer L, Zhao YJ, Ding Q, Zhao Y, Wang L, Wang T, Huang P, Pan Y, Sun B, Li D. Modeling impulsivity and risk aversion in the subthalamic nucleus with deep brain stimulation. NATURE. MENTAL HEALTH 2024; 2:1084-1095. [PMID: 39263364 PMCID: PMC11383798 DOI: 10.1038/s44220-024-00289-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 06/24/2024] [Indexed: 09/13/2024]
Abstract
Risk evaluation is ubiquitous in decisions. Deep brain stimulation of the subthalamic nucleus is effective for Parkinson's disease and obsessive-compulsive disorder, and can be associated with impulsivity and hypomania. Subthalamic stimulation has seemingly contrasting effects on impulsivity enhancing conflict-induced impulsivity but decreasing risk taking. Here, using a card gambling task paired with intracranial recordings (n = 25) and within-subject case control acute stimulation (n = 15) of the right subthalamic nucleus, we dissociated objective risk and uncertainty and subjective physiological markers of risk. Acute stimulation decreased risk taking (P = 0.010, Cohen's d = 0.72) and increased subthalamic theta activity (P < 0.001, Cohen's d = 0.72). Critically, stimulation negatively shifted the relationship between subthalamic physiology and a measure of evidence accumulation similar to observations with stimulation-induced conflict processing. This highlights the phenotypic and physiological heterogeneity of impulsivity, yet linking mechanisms underlying stimulation-induced conflict and risk. Finally, stimulation-induced risk seeking implicates the ventral subthalamic nucleus and dissociating anatomical and functional connectivity with the mesial prefrontal cortex. Our findings have implications for conceptualizations of impulsivity, and clinical relevance for neuropsychiatric disorders.
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Affiliation(s)
- Valerie Voon
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Luis Manssuer
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Yi-Jie Zhao
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Qiong Ding
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Ying Zhao
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Linbin Wang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
| | - Tao Wang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Peng Huang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yixin Pan
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bomin Sun
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dianyou Li
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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4
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Pagnier GJ, Asaad WF, Frank MJ. Double dissociation of dopamine and subthalamic nucleus stimulation on effortful cost/benefit decision making. Curr Biol 2024; 34:655-660.e3. [PMID: 38183986 PMCID: PMC10872531 DOI: 10.1016/j.cub.2023.12.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/10/2023] [Accepted: 12/13/2023] [Indexed: 01/08/2024]
Abstract
Deep brain stimulation (DBS) and dopaminergic therapy (DA) are common interventions for Parkinson's disease (PD). Both treatments typically improve patient outcomes, and both can have adverse side effects on decision making (e.g., impulsivity).1,2 Nevertheless, they are thought to act via different mechanisms within basal ganglia circuits.3 Here, we developed and formally evaluated their dissociable predictions within a single cost/benefit effort-based decision-making task. In the same patients, we manipulated DA medication status and subthalamic nucleus (STN) DBS status within and across sessions. Using a series of descriptive and computational modeling analyses of participant choices and their dynamics, we confirm a double dissociation: DA medication asymmetrically altered participants' sensitivities to benefits vs. effort costs of alternative choices (boosting the sensitivity to benefits while simultaneously lowering sensitivity to costs); whereas STN DBS lowered the decision threshold of such choices. To our knowledge, this is the first study to show, using a common modeling framework, a dissociation of DA and DBS within the same participants. As such, this work offers a comprehensive account for how different mechanisms impact decision making, and how impulsive behavior (present in DA-treated patients with PD and DBS patients) may emerge from separate physiological mechanisms.
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Affiliation(s)
- Guillaume J Pagnier
- Department of Neuroscience, Brown University, Box GL-N, 185 Meeting Street, Providence, RI 02912, USA; Carney Institute for Brain Science, Brown University, 164 Angell Street, 4(th) Floor, Providence, RI 02906, USA.
| | - Wael F Asaad
- Department of Neuroscience, Brown University, Box GL-N, 185 Meeting Street, Providence, RI 02912, USA; Norman Prince Neurosciences Institute, APC 633, Department of Neurosurgery, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903; Carney Institute for Brain Science, Brown University, 164 Angell Street, 4(th) Floor, Providence, RI 02906, USA
| | - Michael J Frank
- Department of Neuroscience, Brown University, Box GL-N, 185 Meeting Street, Providence, RI 02912, USA; Department of Cognitive, Linguistic and Psychological Sciences, Metcalf Research Building, 190 Thayer St, Providence, RI 02912, USA; Carney Institute for Brain Science, Brown University, 164 Angell Street, 4(th) Floor, Providence, RI 02906, USA
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5
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Zacharia A, Kaski D, Bouthour W, Dayal V, Bereau M, Mahlknecht P, Georgiev D, Péron J, Foltynie T, Zrinzo L, Jahanshahi M, Rothwell J, Limousin P. Effects of deep brain stimulation frequency on eye movements and cognitive control. NPJ Parkinsons Dis 2023; 9:50. [PMID: 37002261 PMCID: PMC10066205 DOI: 10.1038/s41531-023-00470-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 02/06/2023] [Indexed: 04/03/2023] Open
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for Parkinson's disease (PD). Varying the frequency DBS has differential effects on axial and distal limb functions, suggesting differing modulation of relevant pathways. The STN is also a critical node in oculomotor and associative networks, but the effect of stimulation frequency on these networks remains unknown. This study aimed to investigate the effects of 80 hz vs. 130 Hz frequency STN-DBS on eye movements and executive control. Twenty-one STN-DBS PD patients receiving 130 Hz vs. 80 Hz stimulation were compared to a healthy control group (n = 16). All participants were tested twice in a double-blind manner. We examined prosaccades (latency and gain) and antisaccades (latency of correct and incorrect antisaccades, error rate and gain of the correct antisaccades). Executive function was tested with the Stroop task. The motor condition was assessed using Unified Parkinson's Disease Rating Scale part III. The antisaccadic error rate was higher in patients (p = 0.0113), more so in patients on 80 Hz compared to 130 Hz (p = 0.001) stimulation. The differences between patients and controls and between frequencies for all other eye-movements or cognitive measures were not statistically significant. We show that 80 Hz STN-DBS in PD reduces the ability to maintain stable fixation but does not alter inhibition, resulting in a higher antisaccade error rate presumably due to less efficient fixation, without altering the motor state. This provides a wider range of stimulation parameters that can reduce specific DBS-related effects without affecting motor outcomes.
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Affiliation(s)
- André Zacharia
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK
- Department of Neurology, Geneva University Hospitals, Geneva, Switzerland
- Department of Neurology, Clinique Bernoise Montana, Crans-, Montana, Switzerland
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Diego Kaski
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Walid Bouthour
- Department of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Viswas Dayal
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Matthieu Bereau
- Department of Neurology, Besançon University Hospital, Besançon, France
| | - Philipp Mahlknecht
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Dejan Georgiev
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK
- Department of Neurology, University Medical Centre, Ljubljana, Slovenia
| | - Julie Péron
- Department of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Tom Foltynie
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Ludvic Zrinzo
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Marjan Jahanshahi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK
| | - John Rothwell
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Patricia Limousin
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK.
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6
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Bingham CS, Petersen MV, Parent M, McIntyre CC. Evolving characterization of the human hyperdirect pathway. Brain Struct Funct 2023; 228:353-365. [PMID: 36708394 PMCID: PMC10716731 DOI: 10.1007/s00429-023-02610-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/11/2023] [Indexed: 01/29/2023]
Abstract
The hyperdirect pathway (HDP) represents the main glutamatergic input to the subthalamic nucleus (STN), through which the motor and prefrontal cerebral cortex can modulate basal ganglia activity. Further, direct activation of the motor HDP is thought to be an important component of therapeutic deep brain stimulation (DBS), mediating the disruption of pathological oscillations. Alternatively, unintended recruitment of the prefrontal HDP may partly explain some cognitive side effects of DBS therapy. Previous work describing the HDP has focused on non-human primate (NHP) histological pathway tracings, diffusion-weighted MRI analysis of human white matter, and electrophysiology studies involving paired cortical recordings with DBS. However, none of these approaches alone yields a complete understanding of the complexities of the HDP. As such, we propose that generative modeling methods hold promise to bridge anatomy and physiology results, from both NHPs and humans, into a more detailed representation of the human HDP. Nonetheless, numerous features of the HDP remain to be experimentally described before model-based methods can simulate corticosubthalamic activity with a high degree of scientific detail. Therefore, the goals of this review are to examine the experimental evidence for HDP projections from across the primate neocortex and discuss new data which are required to improve the utility of anatomical and biophysical models of the human corticosubthalamic system.
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Affiliation(s)
- Clayton S Bingham
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | | | - Martin Parent
- Department of Psychiatry and Neuroscience, Laval University, Quebec, Canada
| | - Cameron C McIntyre
- Department of Biomedical Engineering, Duke University, Durham, NC, USA.
- Department of Neurosurgery, Duke University, Durham, NC, USA.
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7
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Leimbach F, Atkinson-Clement C, Socorro P, Jahanshahi M. The Effects of Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease on Associative Learning of Verbal and Non-Verbal Information by Trial and Error or with Corrective Feedback. JOURNAL OF PARKINSON'S DISEASE 2022; 12:885-896. [PMID: 35342046 DOI: 10.3233/jpd-212843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Parkinson's disease (PD) and subthalamic nucleus deep brain stimulation (STN-DBS) are both known to induce cognitive changes. OBJECTIVE The aim of our study was to investigate the impact of STN-DBS on two forms of conditional associative learning (CAL), trial and error or corrective feedback learning, which differed in difficulty to test the load-dependency hypothesis of the cognitive effects of STN-DBS in PD. METHODS We recruited two groups of PD patients, those who had STN-DBS surgery bilaterally (n = 24) and a second unoperated group (n = 9) who were assessed on two versions of a task of visual CAL involving either a more difficult trial and error learning or a relatively easier corrective feedback learning. Each task was completed twice by both groups, On and Off STN-DBS for the operated group and a first and second time by the unoperated group. RESULTS With STN-DBS Off, corrective feedback learning was superior to trial and error CAL, but not with STN-DBS On. The unoperated PD group had improved performance during the second assessment. To control for the improvement observed with repeated assessment in the PD control group, we split the STN-DBS group into two subgroups based on the condition of the first assessment (Off first vs. On first). While we found no STN-DBS effects for the Off first subgroup (N = 14), we observed improved performance during the second STN-DBS Off session for the On first subgroup (N = 10). CONCLUSION The findings suggest that in PD, STN-DBS interferes with use of corrective feedback and its integration in the conditional associative learning process. Also STN stimulation affected the ability of operated patients to resolve proactive interference during learning of the arbitrary visual associations by trial and error or with corrective feedback.
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Affiliation(s)
- Friederike Leimbach
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Cyril Atkinson-Clement
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, ICM, F-75013, Paris, France.,Movement Investigation and Therapeutics Team, Paris, France.,School of Medicine, University of Nottingham, Nottingham, UK
| | - Pieter Socorro
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Marjan Jahanshahi
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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8
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Reverse Visually Guided Reaching in Patients with Parkinson’s Disease. PARKINSON'S DISEASE 2022; 2022:8132923. [PMID: 35386952 PMCID: PMC8979744 DOI: 10.1155/2022/8132923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 01/11/2022] [Accepted: 02/22/2022] [Indexed: 11/18/2022]
Abstract
In addition to motor symptoms such as difficulty in movement initiation and bradykinesia, patients with Parkinson’s disease (PD) display nonmotor executive cognitive dysfunction with deficits in inhibitory control. Preoperative psychological assessments are used to screen for impulsivity that may be worsened by deep brain stimulation (DBS) of the subthalamic nucleus (STN). However, it is unclear whether anti-Parkinson’s therapy, such as dopamine replacement therapy (DRT) or DBS, which has beneficial effects on motor function, adversely affects inhibitory control or its domains. The detrimental effects of STN-DBS are more apparent when tasks test the inhibition of habitual prepotent responses or involve complex cognitive loads. Our goal was to use a reverse visually guided reaching (RVGR) task, a hand-based version of the antisaccade task, to simultaneously measure motor performance and response inhibition in subjects with PD. We recruited 55 healthy control subjects, 26 PD subjects receiving treatment with DRTs, and 7 PD subjects receiving treatment with STN-DBS and DRTs. In the RVGR task, a cursor moved opposite to the subject’s hand movement. This was compared to visually guided reaching (VGR) where the cursor moved in the same direction as the subject’s hand movement. Reaction time, mean speed, and direction errors (in RVGR) were assessed. Reaction times were longer, and mean speeds were slower during RVGR compared to VGR in all three groups but worse in untreated subjects with PD. Treatment with DRTs, DBS, or DBS + DRT improved the reaction time and speed on the RVGR task to a greater extent than VGR. Additionally, DBS or DBS + DRT demonstrated an increase in direction errors, which was correlated with decreased reaction time. These results show that the RVGR task quantifies the benefit of STN-DBS on bradykinesia and the concomitant reduction of proactive inhibitory control. The RVGR task has the potential to be used to rapidly screen for preoperative deficits in inhibitory control and to titrate STN-DBS, to maximize the therapeutic benefits on movement, and minimize impaired inhibitory control.
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9
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Piszczek L, Constantinescu A, Kargl D, Lazovic J, Pekcec A, Nicholson JR, Haubensak W. Dissociation of impulsive traits by subthalamic metabotropic glutamate receptor 4. eLife 2022; 11:62123. [PMID: 34982027 PMCID: PMC8803315 DOI: 10.7554/elife.62123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/31/2021] [Indexed: 11/17/2022] Open
Abstract
Behavioral strategies require gating of premature responses to optimize outcomes. Several brain areas control impulsive actions, but the neuronal basis of natural variation in impulsivity between individuals remains largely unknown. Here, by combining a Go/No-Go behavioral assay with resting-state (rs) functional MRI in mice, we identified the subthalamic nucleus (STN), a known gate for motor control in the basal ganglia, as a major hotspot for trait impulsivity. In vivo recorded STN neural activity encoded impulsive action as a separable state from basic motor control, characterized by decoupled STN/substantia nigra pars reticulata (SNr) mesoscale networks. Optogenetic modulation of STN activity bidirectionally controlled impulsive behavior. Pharmacological and genetic manipulations showed that these impulsive actions are modulated by metabotropic glutamate receptor 4 (mGlu4) function in STN and its coupling to SNr in a behavioral trait-dependent manner, and independently of general motor function. In conclusion, STN circuitry multiplexes motor control and trait impulsivity, which are molecularly dissociated by mGlu4. This provides a potential mechanism for the genetic modulation of impulsive behavior, a clinically relevant predictor for developing psychiatric disorders associated with impulsivity.
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Affiliation(s)
- Lukasz Piszczek
- The Research Institute of Molecular Pathology (IMP), Department of Neuroscience, Vienna Biocenter, Vienna, Austria
| | - Andreea Constantinescu
- The Research Institute of Molecular Pathology (IMP), Department of Neuroscience, Vienna Biocenter, Vienna, Austria
| | - Dominic Kargl
- The Research Institute of Molecular Pathology (IMP), Department of Neuroscience, Vienna Biocenter, Vienna, Austria.,Department of Neuronal Cell Biology, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Jelena Lazovic
- Preclinical Imaging Facility, Vienna BioCenter Core Facilities (VBCF), Vienna, Austria
| | - Anton Pekcec
- Div Research Germany, Boehringer Ingelheim, Biberach an der Riss, Germany
| | - Janet R Nicholson
- Div Research Germany, Boehringer Ingelheim, Biberach an der Riss, Germany
| | - Wulf Haubensak
- The Research Institute of Molecular Pathology (IMP), Department of Neuroscience, Vienna Biocenter, Vienna, Austria.,Department of Neuronal Cell Biology, Center for Brain Research, Medical University of Vienna, Vienna, Austria
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10
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Lo Buono V, Lucà Trombetta M, Palmeri R, Bonanno L, Cartella E, Di Lorenzo G, Bramanti P, Marino S, Corallo F. Subthalamic nucleus deep brain stimulation and impulsivity in Parkinson's disease: a descriptive review. Acta Neurol Belg 2021; 121:837-847. [PMID: 33961279 PMCID: PMC8349322 DOI: 10.1007/s13760-021-01684-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/15/2021] [Indexed: 11/26/2022]
Abstract
Standard treatment of Parkinson’s disease involves the dopaminergic medications. Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an important neurosurgical intervention often used as alternative treatment to drug therapy; however, it can be associated with increase of impulsive behaviors. This descriptive review focused on studies investigating the correlation between Deep brain stimulation of the subthalamic nucleus and impulsivity in Parkinson’s disease patients, arguing, the action’s mechanism and the specific role of the subthalamic nucleus. We searched on PubMed and Web of Science databases and screening references of included studies and review articles for additional citations. From initial 106 studies, only 15 met the search criteria. Parkinson’s Disease patients with and without Deep Brain Stimulation were compared with healthy controls, through 16 different tasks that assessed some aspects of impulsivity. Both Deep brain stimulation of the subthalamic nucleus and medication were associated with impulsive behavior and influenced decision-making processes. Moreover, findings demonstrated that: Impulse Control Disorders (ICDs) occurred soon after surgery, while, in pharmacological treatment, they appeared mainly after the initiation of treatment or the increase in dosage, especially with dopamine agonists. The subthalamic nucleus plays a part in the fronto-striato-thalamic-cortical loops mediating motor, cognitive, and emotional functions: this could explain the role of the Deep Brain Stimulation in behavior modulation in Parkinson’s Disease patients. Indeed, increase impulsivity has been reported also after deep brain stimulation of the subthalamic nucleus independently by dopaminergic medication status.
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Affiliation(s)
| | | | | | - Lilla Bonanno
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | | | | | | | - Silvia Marino
- IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
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11
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De Pretto M, Mouthon M, Debove I, Pollo C, Schüpbach M, Spierer L, Accolla EA. Proactive inhibition is not modified by deep brain stimulation for Parkinson's disease: An electrical neuroimaging study. Hum Brain Mapp 2021; 42:3934-3949. [PMID: 34110074 PMCID: PMC8288097 DOI: 10.1002/hbm.25530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/23/2021] [Accepted: 05/03/2021] [Indexed: 11/06/2022] Open
Abstract
In predictable contexts, motor inhibitory control can be deployed before the actual need for response suppression. The brain functional underpinnings of proactive inhibition, and notably the role of basal ganglia, are not entirely identified. We investigated the effects of deep brain stimulation of the subthalamic nucleus or internal globus pallidus on proactive inhibition in patients with Parkinson's disease. They completed a cued go/no-go proactive inhibition task ON and (unilateral) OFF stimulation while EEG was recorded. We found no behavioural effect of either subthalamic nucleus or internal globus pallidus deep brain stimulation on proactive inhibition, despite a general improvement of motor performance with subthalamic nucleus stimulation. In the non-operated and subthalamic nucleus group, we identified periods of topographic EEG modulation by the level of proactive inhibition. In the subthalamic nucleus group, source estimation analysis suggested the initial involvement of bilateral frontal and occipital areas, followed by a right lateralized fronto-basal network, and finally of right premotor and left parietal regions. Our results confirm the overall preservation of proactive inhibition capacities in both subthalamic nucleus and internal globus pallidus deep brain stimulation, and suggest a partly segregated network for proactive inhibition, with a preferential recruitment of the indirect pathway.
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Affiliation(s)
- Michael De Pretto
- Neurology Unit, Medicine Section, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Michael Mouthon
- Neurology Unit, Medicine Section, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Ines Debove
- Movement Disorders Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claudio Pollo
- Department of Neurosurgery, Inselspital University Hospital Bern, Bern, Switzerland
| | - Michael Schüpbach
- Movement Disorders Center, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lucas Spierer
- Neurology Unit, Medicine Section, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Ettore A Accolla
- Neurology Unit, Medicine Section, Faculty of Sciences and Medicine, University of Fribourg, Fribourg, Switzerland.,Neurology Unit, Department of Medicine, HFR - Cantonal Hospital Fribourg, Fribourg, Switzerland
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12
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Grassi G, Albani G, Terenzi F, Razzolini L, Ramat S. New pharmacological and neuromodulation approaches for impulsive-compulsive behaviors in Parkinson's disease. Neurol Sci 2021; 42:2673-2682. [PMID: 33852081 DOI: 10.1007/s10072-021-05237-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/07/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION A significant proportion of patients with Parkinson's disease (PD) display a set of impulsive-compulsive behaviors at some point during the course of illness. These behaviors range from the so-called behavioral addictions to dopamine dysregulation syndrome, punding and hoarding disorders. These behaviors have been consistently linked to the use of dopaminergic medications used to treat PD motor symptoms (dopamine agonists, levodopa, and other agents) and less consistently to neuromodulation techniques such as deep brain stimulation (DBS). Since there are still no approved treatments for these conditions, their pharmacological management is still a big challenge for clinicians. METHODS We conducted an extensive review of current pharmacological and neuromodulation literature for the management of impulsive-compulsive disorders in PD patients. RESULTS Pharmacological treatment approaches for impulsive-compulsive behaviors and DDS in PD patients include reduction of levodopa (LD), reduction/cessation of dopamine agonist (DA), and initiation of infusion therapies (apomorphine infusion and duodopa). Also, atomoxetine, a noradrenergic agent approved for the treatment of attention deficit hyperactivity disorder, showed some interesting preliminary results but there is still a lack of controlled longitudinal studies. Finally, while DBS effects on impulsive-compulsive disorders are still controversial, non-invasive techniques (such as transcranial magnetic stimulation and transcranial direct current stimulation) could have a potential positive effect but, again, there is still a lack of controlled trials. CONCLUSION Managing impulsivity and compulsivity in PD patients is still a non-evidence-based challenge for clinicians. Controlled trials on promising approaches such as atomoxetine and non-invasive neuromodulation techniques are needed.
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Affiliation(s)
- Giacomo Grassi
- Brain Center Firenze, Viale Belfiore 36, 5014, Florence, Italy.
| | | | | | - Lorenzo Razzolini
- Brain Center Firenze, Viale Belfiore 36, 5014, Florence, Italy.,University of Florence, Florence, Italy
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van den Wildenberg WPM, van Wouwe NC, Ridderinkhof KR, Neimat JS, Elias WJ, Bashore TR, Wylie SA. Deep-brain stimulation of the subthalamic nucleus improves overriding motor actions in Parkinson's disease. Behav Brain Res 2021; 402:113124. [PMID: 33422595 DOI: 10.1016/j.bbr.2021.113124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/04/2021] [Accepted: 01/04/2021] [Indexed: 11/17/2022]
Abstract
Findings from previous research using the classic stop-signal task indicate that the subthalamic nucleus (STN) plays an important role in the ability to inhibit motor actions. Here we extend these findings using a stop-change task that requires voluntary action override to stop an ongoing motor response and change to an alternative response. Sixteen patients diagnosed with Parkinson's disease (PD) and 16 healthy control participants (HC) performed the stop-change task. PD patients completed the task when deep-brain stimulation (DBS) of the STN was turned on and when it was turned off. Behavioral results indicated that going, stopping, and changing latencies were shortened significantly among PD patients during STN DBS, the former two reductions replicating findings from previous DBS studies using the classic stop-signal task. The shortened go latencies observed among PD patients fell within the control range. In contrast, stopping latencies among PD patients, although reduced significantly, continued to be significantly longer than those of the HC. Like go latencies, stop-change latencies were reduced sufficiently among PD patients for them to fall within the control range, a novel finding. In conclusion, STN DBS produced a general, but differential, improvement in the ability of PD patients to override motor actions. Going, stopping, and stop-change latencies were all shortened, but only going and stop-change latencies were normalized.
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Affiliation(s)
- Wery P M van den Wildenberg
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Brain and Cognition (ABC), University of Amsterdam, Amsterdam, the Netherlands.
| | | | - K Richard Ridderinkhof
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Brain and Cognition (ABC), University of Amsterdam, Amsterdam, the Netherlands
| | - Joseph S Neimat
- Department of Neurosurgery, University of Louisville, Louisville, KY, USA
| | - W Jeffrey Elias
- Department of Neurosurgery, University of Virginia Health Systems, Charlottesville, VA, USA
| | - Theodore R Bashore
- Department of Neurosurgery, University of Louisville, Louisville, KY, USA; School of Psychological Sciences, University of Northern Colorado, Greeley, CO, USA
| | - Scott A Wylie
- Department of Neurosurgery, University of Louisville, Louisville, KY, USA
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14
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Upadhyayula PS, Rennert RC, Martin JR, Yue JK, Yang J, Gillis-Buck EM, Sidhu N, Cheung CK, Lee AT, Hoshide RR, Ciacci JD. Basal impulses: findings from the last twenty years on impulsivity and reward pathways using deep brain stimulation. J Neurosurg Sci 2020; 64:544-551. [PMID: 32972108 DOI: 10.23736/s0390-5616.20.04906-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Deep brain stimulation (DBS) is an important treatment modality for movement disorders. Its role in tasks and processes of higher cortical function continues to increase in importance and relevance. This systematic review investigates the impact of DBS on measures of impulsivity. EVIDENCE ACQUISITION A total of 45 studies were collated from PubMed (30 prospective, 8 animal, 4 questionnaire-based, and 3 computational models), excluding case reports and review articles. Two areas extensively studied are the subthalamic nucleus (STN) and nucleus accumbens (NAc). EVIDENCE SYNTHESIS While both are part of the basal ganglia, the STN and NAc have extensive connections to the prefrontal cortex, cingulate cortex, and limbic system. Therefore, understanding cause and treatment of impulsivity requires understanding motor pathways, learning, memory, and emotional processing. DBS of the STN and NAc shell can increase objective measures of impulsivity, as measured by reaction times or reward-based learning, independent from patient insight. The ability for DBS to treat impulse control disorders, and also cause and/or worsen impulsivity in Parkinson's disease, may be explained by the affected closely-related neuroanatomical areas with discrete and sometimes opposing functions. CONCLUSIONS As newer, more refined DBS technology emerges, large-scale prospective studies specifically aimed at treatment of impulsivity disorders are needed.
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Affiliation(s)
- Pavan S Upadhyayula
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Robert C Rennert
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Joel R Martin
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - John K Yue
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Jason Yang
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Eva M Gillis-Buck
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Nikki Sidhu
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Christopher K Cheung
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Anthony T Lee
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Reid R Hoshide
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA
| | - Joseph D Ciacci
- Department of Neurological Surgery, University of California San Diego, San Diego, CA, USA -
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15
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Bateman DR, Gill S, Hu S, Foster ED, Ruthirakuhan MT, Sellek AF, Mortby ME, Matušková V, Ng KP, Tarawneh RM, Freund-Levi Y, Kumar S, Gauthier S, Rosenberg PB, Ferreira de Oliveira F, Devanand DP, Ballard C, Ismail Z. Agitation and impulsivity in mid and late life as possible risk markers for incident dementia. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12016. [PMID: 32995467 PMCID: PMC7507499 DOI: 10.1002/trc2.12016] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 02/17/2020] [Indexed: 12/14/2022]
Abstract
To identify knowledge gaps regarding new-onset agitation and impulsivity prior to onset of cognitive impairment or dementia the International Society to Advance Alzheimer's Research and Treatment Neuropsychiatric Syndromes (NPS) Professional Interest Area conducted a scoping review. Extending a series of reviews exploring the pre-dementia risk syndrome Mild Behavioral Impairment (MBI), we focused on late-onset agitation and impulsivity (the MBI impulse dyscontrol domain) and risk of incident cognitive decline and dementia. This scoping review of agitation and impulsivity pre-dementia syndromes summarizes the current biomedical literature in terms of epidemiology, diagnosis and measurement, neurobiology, neuroimaging, biomarkers, course and prognosis, treatment, and ongoing clinical trials. Validations for pre-dementia scales such as the MBI Checklist, and incorporation into longitudinal and intervention trials, are needed to better understand impulse dyscontrol as a risk factor for mild cognitive impairment and dementia.
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Affiliation(s)
- Daniel R Bateman
- Department of Psychiatry Indiana University School of Medicine Indianapolis Indiana
- Indiana University Center for Aging Research Regenstrief Institute Indianapolis Indiana
| | - Sascha Gill
- Department of Clinical Neurosciences; and the Ron and Rene Ward Centre for Healthy Brain Aging Research; Hotchkiss Brain Institute University of Calgary Calgary Alberta Canada
| | - Sophie Hu
- Community Health Sciences, and O'Brien Institute for Public Health University of Calgary Calgary Alberta Canada
| | - Erin D Foster
- Ruth Lilly Medical Library Indiana University School of Medicine Indianapolis Indiana
- University of California Berkeley Berkeley CA
| | - Myuri T Ruthirakuhan
- Hurvitz Brain Sciences Research Program Sunnybrook Research Institute Toronto Ontario Canada
- Department of Pharmacology and Toxicology University of Toronto Ontario Canada
| | | | - Moyra E Mortby
- School of Psychology University of New South Wales Sydney New South Wales Australia
- Neuroscience Research Australia University of New South Wales Sydney New South Wales Australia
| | - Veronika Matušková
- International Clinical Research Center St. Anne's University Hospital Brno Brno Czech Republic
- Memory Disorders Clinic, Department of Neurology, 2nd Faculty of Medicine Charles University in Prague and Motol University Hospital Prague Czech Republic
| | - Kok Pin Ng
- Department of Neurology National Neuroscience Institute Singapore Singapore
| | - Rawan M Tarawneh
- Department of Neurology, College of Medicine The Ohio State University Columbus Ohio USA
| | - Yvonne Freund-Levi
- Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society Karolinska Institute Stockholm Sweden
- School of Medical Sciences Örebro University Örebro Sweden
| | - Sanjeev Kumar
- Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Psychiatry University of Toronto Ontario Canada
| | - Serge Gauthier
- McGill Center for Studies in Aging McGill University Montreal Quebec Canada
| | - Paul B Rosenberg
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral, Sciences Johns Hopkins University School of Medicine Baltimore Maryland
| | - Fabricio Ferreira de Oliveira
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina Federal University of São Paulo (UNIFESP), São Paulo São Paulo Brazil
| | - D P Devanand
- New York State Psychiatric Institute and Department of Psychiatry and Department of Psychiatry, College of Physicians and Surgeons Columbia University New York New York
| | - Clive Ballard
- College of Medicine and Health The University of Exeter Exeter UK
| | - Zahinoor Ismail
- Department of Clinical Neurosciences; and the Ron and Rene Ward Centre for Healthy Brain Aging Research; Hotchkiss Brain Institute University of Calgary Calgary Alberta Canada
- Community Health Sciences, and O'Brien Institute for Public Health University of Calgary Calgary Alberta Canada
- Department of Psychiatry, and the Mathison Centre for Mental Health Research & Education Cumming School of Medicine, University of Calgary Calgary Alberta Canada
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16
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Drummond NM, Chen R. Deep brain stimulation and recordings: Insights into the contributions of subthalamic nucleus in cognition. Neuroimage 2020; 222:117300. [PMID: 32828919 DOI: 10.1016/j.neuroimage.2020.117300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/28/2020] [Accepted: 08/17/2020] [Indexed: 12/13/2022] Open
Abstract
Recent progress in targeted interrogation of basal ganglia structures and networks with deep brain stimulation in humans has provided insights into the complex functions the subthalamic nucleus (STN). Beyond the traditional role of the STN in modulating motor function, recognition of its role in cognition was initially fueled by side effects seen with STN DBS and later revealed with behavioral and electrophysiological studies. Anatomical, clinical, and electrophysiological data converge on the view that the STN is a pivotal node linking cognitive and motor processes. The goal of this review is to synthesize the literature to date that used DBS to examine the contributions of the STN to motor and non-motor cognitive functions and control. Multiple modalities of research have provided us with an enhanced understanding of the STN and reveal that it is critically involved in motor and non-motor inhibition, decision-making, motivation and emotion. Understanding the role of the STN in cognition can enhance the therapeutic efficacy and selectivity not only for existing applications of DBS, but also in the development of therapeutic strategies to stimulate aberrant circuits to treat non-motor symptoms of Parkinson's disease and other disorders.
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Affiliation(s)
- Neil M Drummond
- Krembil Research Institute, University Health Network, Toronto, ON M5T 2S8, Canada.
| | - Robert Chen
- Krembil Research Institute, University Health Network, Toronto, ON M5T 2S8, Canada; Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada
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17
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Peters J, D’Esposito M. The drift diffusion model as the choice rule in inter-temporal and risky choice: A case study in medial orbitofrontal cortex lesion patients and controls. PLoS Comput Biol 2020; 16:e1007615. [PMID: 32310962 PMCID: PMC7192518 DOI: 10.1371/journal.pcbi.1007615] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 04/30/2020] [Accepted: 12/19/2019] [Indexed: 01/20/2023] Open
Abstract
Sequential sampling models such as the drift diffusion model (DDM) have a long tradition in research on perceptual decision-making, but mounting evidence suggests that these models can account for response time (RT) distributions that arise during reinforcement learning and value-based decision-making. Building on this previous work, we implemented the DDM as the choice rule in inter-temporal choice (temporal discounting) and risky choice (probability discounting) using hierarchical Bayesian parameter estimation. We validated our approach in data from nine patients with focal lesions to the ventromedial prefrontal cortex / medial orbitofrontal cortex (vmPFC/mOFC) and nineteen age- and education-matched controls. Model comparison revealed that, for both tasks, the data were best accounted for by a variant of the drift diffusion model including a non-linear mapping from value-differences to trial-wise drift rates. Posterior predictive checks confirmed that this model provided a superior account of the relationship between value and RT. We then applied this modeling framework and 1) reproduced our previous results regarding temporal discounting in vmPFC/mOFC patients and 2) showed in a previously unpublished data set on risky choice that vmPFC/mOFC patients exhibit increased risk-taking relative to controls. Analyses of DDM parameters revealed that patients showed substantially increased non-decision times and reduced response caution during risky choice. In contrast, vmPFC/mOFC damage abolished neither scaling nor asymptote of the drift rate. Relatively intact value processing was also confirmed using DDM mixture models, which revealed that in both groups >98% of trials were better accounted for by a DDM with value modulation than by a null model without value modulation. Our results highlight that novel insights can be gained from applying sequential sampling models in studies of inter-temporal and risky decision-making in cognitive neuroscience.
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Affiliation(s)
- Jan Peters
- Department of Psychology, Biological Psychology, University of Cologne, Germany
- * E-mail:
| | - Mark D’Esposito
- Helen Wills Neuroscience Institute, University of California at Berkeley, Berkeley, California, United States of America
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18
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Subjective estimates of uncertainty during gambling and impulsivity after subthalamic deep brain stimulation for Parkinson's disease. Sci Rep 2019; 9:14795. [PMID: 31616015 PMCID: PMC6794275 DOI: 10.1038/s41598-019-51164-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 09/25/2019] [Indexed: 01/08/2023] Open
Abstract
Subthalamic deep brain stimulation (DBS) for Parkinson’s disease (PD) may modulate chronometric and instrumental aspects of choice behaviour, including motor inhibition, decisional slowing, and value sensitivity. However, it is not well known whether subthalamic DBS affects more complex aspects of decision-making, such as the influence of subjective estimates of uncertainty on choices. In this study, 38 participants with PD played a virtual casino prior to subthalamic DBS (whilst ‘on’ medication) and again, 3-months postoperatively (whilst ‘on’ stimulation). At the group level, there was a small but statistically significant decrease in impulsivity postoperatively, as quantified by the Barratt Impulsiveness Scale (BIS). The gambling behaviour of participants (bet increases, slot machine switches and double or nothing gambles) was associated with this self-reported measure of impulsivity. However, there was a large variance in outcome amongst participants, and we were interested in whether individual differences in subjective estimates of uncertainty (specifically, volatility) were related to differences in pre- and postoperative impulsivity. To examine these individual differences, we fit a computational model (the Hierarchical Gaussian Filter, HGF), to choices made during slot machine game play as well as a simpler reinforcement learning model based on the Rescorla-Wagner formalism. The HGF was superior in accounting for the behaviour of our participants, suggesting that participants incorporated beliefs about environmental uncertainty when updating their beliefs about gambling outcome and translating these beliefs into action. A specific aspect of subjective uncertainty, the participant’s estimate of the tendency of the slot machine’s winning probability to change (volatility), increased subsequent to DBS. Additionally, the decision temperature of the response model decreased post-operatively, implying greater stochasticity in the belief-to-choice mapping of participants. Model parameter estimates were significantly associated with impulsivity; specifically, increased uncertainty was related to increased postoperative impulsivity. Moreover, changes in these parameter estimates were significantly associated with the maximum post-operative change in impulsivity over a six month follow up period. Our findings suggest that impulsivity in PD patients may be influenced by subjective estimates of uncertainty (environmental volatility) and implicate a role for the subthalamic nucleus in the modulation of outcome certainty. Furthermore, our work outlines a possible approach to characterising those persons who become more impulsive after subthalamic DBS, an intervention in which non-motor outcomes can be highly variable.
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19
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Hedge C, Vivian-Griffiths S, Powell G, Bompas A, Sumner P. Slow and steady? Strategic adjustments in response caution are moderately reliable and correlate across tasks. Conscious Cogn 2019; 75:102797. [PMID: 31421398 PMCID: PMC6920044 DOI: 10.1016/j.concog.2019.102797] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/25/2019] [Accepted: 07/23/2019] [Indexed: 01/19/2023]
Abstract
Speed-accuracy trade-offs are often considered a confound in speeded choice tasks, but individual differences in strategy have been linked to personality and brain structure. We ask whether strategic adjustments in response caution are reliable, and whether they correlate across tasks and with impulsivity traits. In Study 1, participants performed Eriksen flanker and Stroop tasks in two sessions four weeks apart. We manipulated response caution by emphasising speed or accuracy. We fit the diffusion model for conflict tasks and correlated the change in boundary (accuracy - speed) across session and task. We observed moderate test-retest reliability, and medium to large correlations across tasks. We replicated this between-task correlation in Study 2 using flanker and perceptual decision tasks. We found no consistent correlations with impulsivity. Though moderate reliability poses a challenge for researchers interested in stable traits, consistent correlation between tasks indicates there are meaningful individual differences in the speed-accuracy trade-off.
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Affiliation(s)
- Craig Hedge
- School of Psychology, Cardiff University, UK.
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20
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Meynen G. Forensic psychiatry and neurolaw: Description, developments, and debates. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2019; 65:101345. [PMID: 29724513 DOI: 10.1016/j.ijlp.2018.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 04/05/2018] [Indexed: 06/08/2023]
Abstract
Neuroscience produces a wealth of data on the relationship between brain and behavior, including criminal behavior. The research field studying the possible and actual impact of neuroscience on the law and legal practices, is called neurolaw. It is a new and rapidly developing domain of interdisciplinary research. Since forensic psychiatry has to do with both neuroscience and the law, neurolaw is of specific relevance for this psychiatric specialty. In this contribution, I will discuss three main research areas in neurolaw - revision, assessment, and intervention - and explore their relevance for forensic psychiatry. I will identify some valuable possibilities as well as some notable challenges - both technical and ethical - for forensic psychiatry regarding neurolaw developments.
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Affiliation(s)
- Gerben Meynen
- Department of Criminal Law, Tilburg Law School, Tilburg University, The Netherlands; Department of Philosophy, Faculty of Humanities, Vrije Universiteit Amsterdam, The Netherlands.
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21
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London D, Pourfar MH, Mogilner AY. Deep Brain Stimulation of the Subthalamic Nucleus Induces Impulsive Responses to Bursts of Sensory Evidence. Front Neurosci 2019; 13:270. [PMID: 30983958 PMCID: PMC6450191 DOI: 10.3389/fnins.2019.00270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/07/2019] [Indexed: 01/05/2023] Open
Abstract
Decisions are made through the integration of external and internal inputs until a threshold is reached, triggering a response. The subthalamic nucleus (STN) has been implicated in adjusting the decision bound to prevent impulsivity during difficult decisions. We combine model-based and model-free approaches to test the theory that the STN raises the decision bound, a process impaired by deep brain stimulation (DBS). Eight male and female human subjects receiving treatment for Parkinson's disease with bilateral DBS of the STN performed an auditory two-alternative forced choice task. By ending trials unpredictably, we collected reaction time (RT) trials in which subjects reached their decision bound and non-RT trials in which subjects were forced to make a decision with less evidence. A decreased decision bound would cause worse performance on RT trials, and we found this to be the case on left-sided RT trials. Drift diffusion modeling showed a negative drift rate. This implies that in the absence of new evidence, the amount of evidence accumulated tends to drift toward zero. If evidence is accumulated at a constant rate this results in the evidence accumulated reaching an asymptote, the distance of which from the bound was decreased by DBS (p = 0.0079, random shuffle test), preventing subjects from controlling impulsivity. Subjects were more impulsive to bursts of stimuli associated with conflict (p < 0.001, cluster mass test). In addition, DBS lowered the decision bound specifically after error trials, decreasing the probability of switching to a non-RT trial after an error compared to correct response (28% vs. 38%, p = 0.005, Fisher exact test). The STN appears to function in decision-making by modulating the decision bound and drift rate to allow the suppression of impulsive responses.
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Affiliation(s)
- Dennis London
- Department of Neurosurgery, Center for Neuromodulation, NYU Langone Health, New York, NY, United States
| | - Michael H Pourfar
- Department of Neurosurgery, Center for Neuromodulation, NYU Langone Health, New York, NY, United States
| | - Alon Y Mogilner
- Department of Neurosurgery, Center for Neuromodulation, NYU Langone Health, New York, NY, United States
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22
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Eisinger RS, Ramirez-Zamora A, Carbunaru S, Ptak B, Peng-Chen Z, Okun MS, Gunduz A. Medications, Deep Brain Stimulation, and Other Factors Influencing Impulse Control Disorders in Parkinson's Disease. Front Neurol 2019; 10:86. [PMID: 30863353 PMCID: PMC6399407 DOI: 10.3389/fneur.2019.00086] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 01/22/2019] [Indexed: 12/18/2022] Open
Abstract
Impulse control disorders (ICDs) in Parkinson's disease (PD) have a high cumulative incidence and negatively impact quality of life. ICDs are influenced by a complex interaction of multiple factors. Although it is now well-recognized that dopaminergic treatments and especially dopamine agonists underpin many ICDs, medications alone are not the sole cause. Susceptibility to ICD is increased in the setting of PD. While causality can be challenging to ascertain, a wide range of modifiable and non-modifiable risk factors have been linked to ICDs. Common characteristics of PD patients with ICDs have been consistently identified across many studies; for example, males with an early age of PD onset and dopamine agonist use have a higher risk of ICD. However, not all cases of ICDs in PD can be directly attributable to dopamine, and studies have concluded that additional factors such as genetics, smoking, and/or depression may be more predictive. Beyond dopamine, other ICD associations have been described but remain difficult to explain, including deep brain stimulation surgery, especially in the setting of a reduction in dopaminergic medication use. In this review, we will summarize the demographic, genetic, behavioral, and clinical contributions potentially influencing ICD onset in PD. These associations may inspire future preventative or therapeutic strategies.
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Affiliation(s)
- Robert S. Eisinger
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Adolfo Ramirez-Zamora
- Hospital Padre Hurtado, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Samuel Carbunaru
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Brandon Ptak
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Zhongxing Peng-Chen
- Hospital Padre Hurtado, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Michael S. Okun
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
- Department of Neurology, Fixel Center for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Aysegul Gunduz
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
- Department of Biomedical Engineering, University of Florida, Gainesville, FL, United States
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23
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Atkinson-Clement C, Cavazzini É, Zénon A, Witjas T, Fluchère F, Azulay JP, Baunez C, Eusebio A. Effects of subthalamic nucleus stimulation and levodopa on decision-making in Parkinson's disease. Mov Disord 2019; 34:377-385. [PMID: 30681186 DOI: 10.1002/mds.27625] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/26/2018] [Accepted: 11/30/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is frequently associated with behavioral disorders, particularly within the spectrum of motivated behaviors such as apathy or impulsivity. Both pharmacological and neurosurgical treatments have an impact on these impairments. However, there still is controversy as to whether subthalamic nucleus deep brain stimulation (STN-DBS) can cause or reduce impulsive behaviors. OBJECTIVES We aimed to identify the influence of functional surgery on decision-making processes in PD. METHODS We studied 13 PD patients and 13 healthy controls. The experimental task involved squeezing a dynamometer with variable force to obtain rewards of various values under four conditions: without treatment, with l-dopa or subthalamic stimulation alone, and with both l-dopa and subthalamic stimulation. Statistical analyses consisted of generalized linear mixed models including treatment condition, reward value, level of effort, and their interactions. We analyzed acceptance rate (the percentage of accepted trials), decision time, and force applied. RESULTS Comparatively to controls, patients without treatment exhibited lower acceptance rate and force applied. Patients under l-dopa alone did not exhibit increased acceptance rate. With subthalamic stimulation, either with or without added l-dopa, all measures were improved so that patients' behaviors were undistinguishable from healthy controls'. CONCLUSIONS Our study shows that l-dopa administration does not fully restore cost-benefit decision-making processes, whereas STN-DBS fully normalizes patients' behaviors. These findings suggest that dopamine is partly involved in cost-benefit valuation, and that STN-DBS can have a beneficial effect on motivated behaviors in PD and may improve certain forms of impulsive behaviors. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Cyril Atkinson-Clement
- Aix Marseille Université, CNRS, LPL, Aix-en-Provence, France.,Aix Marseille Université, CNRS, INT, Inst Neurosci Timone, Marseille, France
| | | | - Alexandre Zénon
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium.,INCIA, Université de Bordeaux, CNRS UMR5287, Bordeaux, France
| | - Tatiana Witjas
- Aix Marseille Université, CNRS, INT, Inst Neurosci Timone, Marseille, France.,Aix Marseille Université, APHM, CHU Timone, Department of Neurology and Movement Disorders, Marseille, France
| | - Frédérique Fluchère
- Aix Marseille Université, APHM, CHU Timone, Department of Neurology and Movement Disorders, Marseille, France.,Aix Marseille Université, CNRS, LNC, Marseille, France
| | - Jean-Philippe Azulay
- Aix Marseille Université, CNRS, INT, Inst Neurosci Timone, Marseille, France.,Aix Marseille Université, APHM, CHU Timone, Department of Neurology and Movement Disorders, Marseille, France
| | - Christelle Baunez
- Aix Marseille Université, CNRS, INT, Inst Neurosci Timone, Marseille, France
| | - Alexandre Eusebio
- Aix Marseille Université, CNRS, INT, Inst Neurosci Timone, Marseille, France.,Aix Marseille Université, APHM, CHU Timone, Department of Neurology and Movement Disorders, Marseille, France
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24
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Voigt JS. Bodily Felt Freedom: an Ethical Perspective on Positive Aspects of Deep Brain Stimulation. NEUROETHICS-NETH 2018. [DOI: 10.1007/s12152-018-9380-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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The neuroanatomical and neurochemical basis of apathy and impulsivity in frontotemporal lobar degeneration. Curr Opin Behav Sci 2018; 22:14-20. [PMID: 31032387 DOI: 10.1016/j.cobeha.2017.12.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Apathy and impulsivity are common and often coexistent consequences of frontotemporal lobar degeneration (FTLD). They increase patient morbidity and carer distress, but remain under-estimated and poorly treated. Recent trans-diagnostic approaches that span the spectrum of clinical presentations of FTLD and parkinsonism, indicate that apathy and impulsivity can be fractionated into multiple neuroanatomical and pharmacological systems. These include ventral/dorsal fronto-striatal circuits for reward-sensitivity, response-inhibition, and decision-making; moderated by noradrenaline, dopamine, and serotonin. Improved assessment tools, formal models of cognition and behavior, combined with brain imaging and psycho-pharmacology, are creating new therapeutic targets and establishing principles for stratification in future clinical trials.
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26
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Leimbach F, Georgiev D, Litvak V, Antoniades C, Limousin P, Jahanshahi M, Bogacz R. Deep Brain Stimulation of the Subthalamic Nucleus Does Not Affect the Decrease of Decision Threshold during the Choice Process When There Is No Conflict, Time Pressure, or Reward. J Cogn Neurosci 2018; 30:876-884. [PMID: 29488846 PMCID: PMC6037388 DOI: 10.1162/jocn_a_01252] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
During a decision process, the evidence supporting alternative options is integrated over time, and the choice is made when the accumulated evidence for one of the options reaches a decision threshold. Humans and animals have an ability to control the decision threshold, that is, the amount of evidence that needs to be gathered to commit to a choice, and it has been proposed that the subthalamic nucleus (STN) is important for this control. Recent behavioral and neurophysiological data suggest that, in some circumstances, the decision threshold decreases with time during choice trials, allowing overcoming of indecision during difficult choices. Here we asked whether this within-trial decrease of the decision threshold is mediated by the STN and if it is affected by disrupting information processing in the STN through deep brain stimulation (DBS). We assessed 13 patients with Parkinson disease receiving bilateral STN DBS six or more months after the surgery, 11 age-matched controls, and 12 young healthy controls. All participants completed a series of decision trials, in which the evidence was presented in discrete time points, which allowed more direct estimation of the decision threshold. The participants differed widely in the slope of their decision threshold, ranging from constant threshold within a trial to steeply decreasing. However, the slope of the decision threshold did not depend on whether STN DBS was switched on or off and did not differ between the patients and controls. Furthermore, there was no difference in accuracy and RT between the patients in the on and off stimulation conditions and healthy controls. Previous studies that have reported modulation of the decision threshold by STN DBS or unilateral subthalamotomy in Parkinson disease have involved either fast decision-making under conflict or time pressure or in anticipation of high reward. Our findings suggest that, in the absence of reward, decision conflict, or time pressure for decision-making, the STN does not play a critical role in modulating the within-trial decrease of decision thresholds during the choice process.
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Affiliation(s)
| | | | | | | | | | - Marjan Jahanshahi
- University College London Institute of Neurology.,University of Electronic Science and Technology of China
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27
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Hell F, Taylor PCJ, Mehrkens JH, Bötzel K. Subthalamic stimulation, oscillatory activity and connectivity reveal functional role of STN and network mechanisms during decision making under conflict. Neuroimage 2018; 171:222-233. [PMID: 29307607 DOI: 10.1016/j.neuroimage.2018.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/27/2017] [Accepted: 01/01/2018] [Indexed: 01/12/2023] Open
Abstract
Inhibitory control is an important executive function that is necessary to suppress premature actions and to block interference from irrelevant stimuli. Current experimental studies and models highlight proactive and reactive mechanisms and claim several cortical and subcortical structures to be involved in response inhibition. However, the involved structures, network mechanisms and the behavioral relevance of the underlying neural activity remain debated. We report cortical EEG and invasive subthalamic local field potential recordings from a fully implanted sensing neurostimulator in Parkinson's patients during a stimulus- and response conflict task with and without deep brain stimulation (DBS). DBS made reaction times faster overall while leaving the effects of conflict intact: this lack of any effect on conflict may have been inherent to our task encouraging a high level of proactive inhibition. Drift diffusion modelling hints that DBS influences decision thresholds and drift rates are modulated by stimulus conflict. Both cortical EEG and subthalamic (STN) LFP oscillations reflected reaction times (RT). With these results, we provide a different interpretation of previously conflict-related oscillations in the STN and suggest that the STN implements a general task-specific decision threshold. The timecourse and topography of subthalamic-cortical oscillatory connectivity suggest the involvement of motor, frontal midline and posterior regions in a larger network with complementary functionality, oscillatory mechanisms and structures. While beta oscillations are functionally associated with motor cortical-subthalamic connectivity, low frequency oscillations reveal a subthalamic-frontal-posterior network. With our results, we suggest that proactive as well as reactive mechanisms and structures are involved in implementing a task-related dynamic inhibitory signal. We propose that motor and executive control networks with complementary oscillatory mechanisms are tonically active, react to stimuli and release inhibition at the response when uncertainty is resolved and return to their default state afterwards.
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Affiliation(s)
- Franz Hell
- Department of Neurology, Ludwig-Maximilians-Universität München, Marchioninistr. 15, D-81377 Munich, Germany; Graduate School of Systemic Neurosciences, GSN, Ludwig-Maximilians-Universität München, Grosshadernerstr. 2, D-82152 Martinsried, Germany.
| | - Paul C J Taylor
- Department of Neurology, Ludwig-Maximilians-Universität München, Marchioninistr. 15, D-81377 Munich, Germany; Graduate School of Systemic Neurosciences, GSN, Ludwig-Maximilians-Universität München, Grosshadernerstr. 2, D-82152 Martinsried, Germany; German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Marchioninistr. 15, D-81377 Munich, Germany
| | - Jan H Mehrkens
- Department of Neurosurgery, Ludwig-Maximilians-Universität München, Marchioninistr. 15, D-81377 Munich, Germany
| | - Kai Bötzel
- Department of Neurology, Ludwig-Maximilians-Universität München, Marchioninistr. 15, D-81377 Munich, Germany; Graduate School of Systemic Neurosciences, GSN, Ludwig-Maximilians-Universität München, Grosshadernerstr. 2, D-82152 Martinsried, Germany
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28
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Jahanshahi M, Rothwell JC. Inhibitory dysfunction contributes to some of the motor and non-motor symptoms of movement disorders and psychiatric disorders. Philos Trans R Soc Lond B Biol Sci 2017; 372:rstb.2016.0198. [PMID: 28242732 DOI: 10.1098/rstb.2016.0198] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2016] [Indexed: 12/13/2022] Open
Abstract
Recently, it has been proposed that similar to goal-directed and habitual action mediated by the fronto-striatal circuits, the fronto-striato-subthalamic-pallidal-thalamo-cortical network may also mediate goal-directed and habitual (automatic) inhibition in both the motor and non-motor domains. Within this framework, some of the clinical manifestations of Parkinson's disease, dystonia, Tourette syndrome and obsessive-compulsive disorder can be considered to represent an imbalance between goal-directed and habitual action and inhibition. It is possible that surgical interventions targeting the basal ganglia nuclei, such as deep brain stimulation of the subthalamic nucleus or the internal segment of the globus pallidus, improve these disorders by restoring a functional balance between facilitation and inhibition in the fronto-striatal networks. These proposals require investigation in future studies.This article is part of the themed issue 'Movement suppression: brain mechanisms for stopping and stillness'.
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Affiliation(s)
- Marjan Jahanshahi
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, 33 Queen Square, London WC1N 3BG, UK
| | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, 33 Queen Square, London WC1N 3BG, UK
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29
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Evidence for a task-dependent switch in subthalamo-nigral basal ganglia signaling. Nat Commun 2017; 8:1039. [PMID: 29051496 PMCID: PMC5715140 DOI: 10.1038/s41467-017-01023-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 08/13/2017] [Indexed: 01/05/2023] Open
Abstract
Basal ganglia (BG) can either facilitate or inhibit movement through excitatory and inhibitory pathways; however whether these opposing signals are dynamically regulated during healthy behavior is not known. Here, we present compelling neurophysiological evidence from three complimentary experiments in non-human primates, indicating task-specific changes in tonic BG pathway weightings during saccade behavior with different cognitive demands. First, simultaneous local field potential recording in the subthalamic nucleus (STN; BG input) and substantia nigra pars reticulata (SNr; BG output) reveals task-dependent shifts in subthalamo-nigral signals. Second, unilateral electrical stimulation of the STN, SNr, and caudate nucleus results in strikingly different saccade directionality and latency biases across the BG. Third, a simple artificial neural network representing canonical BG signaling pathways suggests that pathway weightings can be altered by cortico-BG input activation. Overall, inhibitory pathways (striato-pallidal-subthalamo-nigral) dominate during goal-driven behavior with instructed rewards, while facilitatory pathways (striato-nigral and subthalamo-pallidal-nigral) dominate during unconstrained (free reward) conditions. Basal ganglia can both facilitate or inhibit movement through excitatory and inhibitory pathways; however whether these opposing signals are dynamically regulated during behavior is not known. Here the authors use multinucleus LFP recordings and electrical microstimulation in monkeys performing saccade based tasks to show task specific changes in the tonic weighting of these pathways.
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30
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Herz DM, Tan H, Brittain JS, Fischer P, Cheeran B, Green AL, FitzGerald J, Aziz TZ, Ashkan K, Little S, Foltynie T, Limousin P, Zrinzo L, Bogacz R, Brown P. Distinct mechanisms mediate speed-accuracy adjustments in cortico-subthalamic networks. eLife 2017; 6. [PMID: 28137358 PMCID: PMC5287713 DOI: 10.7554/elife.21481] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 01/15/2017] [Indexed: 01/29/2023] Open
Abstract
Optimal decision-making requires balancing fast but error-prone and more accurate but slower decisions through adjustments of decision thresholds. Here, we demonstrate two distinct correlates of such speed-accuracy adjustments by recording subthalamic nucleus (STN) activity and electroencephalography in 11 Parkinson’s disease patients during a perceptual decision-making task; STN low-frequency oscillatory (LFO) activity (2–8 Hz), coupled to activity at prefrontal electrode Fz, and STN beta activity (13–30 Hz) coupled to electrodes C3/C4 close to motor cortex. These two correlates differed not only in their cortical topography and spectral characteristics but also in the relative timing of recruitment and in their precise relationship with decision thresholds. Increases of STN LFO power preceding the response predicted increased thresholds only after accuracy instructions, while cue-induced reductions of STN beta power decreased thresholds irrespective of instructions. These findings indicate that distinct neural mechanisms determine whether a decision will be made in haste or with caution. DOI:http://dx.doi.org/10.7554/eLife.21481.001 In everyday decisions, we have to balance how quickly we need to make a decision with how accurate we want our decision to be. For example, if you plan your next holiday you might want to make sure that you pick the best destination without caring too much about the time it takes to arrive at that decision. On the other hand, in your lunch break you might want to quickly choose between the different meals on the menu to make sure you are back at work on time, even though you might overlook a dish that you would have preferred. This effect – that decisions we make in haste are more likely to be suboptimal than slower, more deliberate decisions – is known as the speed-accuracy trade-off. One theory suggests that the activity of a brain area termed the subthalamic nucleus reflects whether people will prioritize speed or accuracy during decision-making. This area is seated deep inside the brain, meaning that it is normally difficult to record its activity. Herz et al. have now recorded the activity of the subthalamic nucleus in individuals with Parkinson’s disease who underwent brain surgery as part of their treatment. When these individuals switched between fast and cautious decision-making, the activity in the subthalamic nucleus changed, as did its relationship with the activity seen in other brain areas. Furthermore, these activity changes predicted how much information participants acquired before committing to a choice. Deep brain stimulation of the subthalamic nucleus is now a standard treatment for Parkinson’s disease. It will be important to assess whether this treatment affects the changes in subthalamic activity that are related to decision-making, and whether this affects whether an individual is more likely to make fast or accurate decisions. DOI:http://dx.doi.org/10.7554/eLife.21481.002
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Affiliation(s)
- Damian M Herz
- Medical Research Council Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom.,Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Huiling Tan
- Medical Research Council Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom.,Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - John-Stuart Brittain
- Medical Research Council Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom.,Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Petra Fischer
- Medical Research Council Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom.,Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Binith Cheeran
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Alexander L Green
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - James FitzGerald
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Tipu Z Aziz
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Keyoumars Ashkan
- Department of Neurosurgery, King's College Hospital, London, United Kingdom
| | - Simon Little
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology, London, United Kingdom
| | - Thomas Foltynie
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology, London, United Kingdom
| | - Patricia Limousin
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology, London, United Kingdom
| | - Ludvic Zrinzo
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology, London, United Kingdom
| | - Rafal Bogacz
- Medical Research Council Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom.,Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Peter Brown
- Medical Research Council Brain Network Dynamics Unit at the University of Oxford, Oxford, United Kingdom.,Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
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31
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Huang YT, Georgiev D, Foltynie T, Limousin P, Speekenbrink M, Jahanshahi M. Different effects of dopaminergic medication on perceptual decision-making in Parkinson's disease as a function of task difficulty and speed–accuracy instructions. Neuropsychologia 2015; 75:577-87. [DOI: 10.1016/j.neuropsychologia.2015.07.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 07/09/2015] [Accepted: 07/10/2015] [Indexed: 11/29/2022]
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