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Wang L, Li J, Pan Y, Huang P, Li D, Voon V. Subacute alpha frequency (10Hz) subthalamic stimulation for emotional processing in Parkinson's disease. Brain Stimul 2023; 16:1223-1231. [PMID: 37567462 DOI: 10.1016/j.brs.2023.08.005] [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: 01/18/2023] [Revised: 05/21/2023] [Accepted: 08/07/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Psychiatric comorbidities are common in Parkinson's disease (PD) and may change with high-frequency stimulation targeting the subthalamic nucleus. Numerous accounts indicate subthalamic alpha-frequency oscillation is implicated in emotional processing. While intermittent alpha-frequency (10Hz) stimulation induces positive emotional effects, with more ventromedial contacts inducing larger effects, little is known about the subacute effect of ventral 10Hz subthalamic stimulation on emotional processing. OBJECTIVE/HYPOTHESIS To evaluate the subacute effect of 10Hz stimulation at bilateral ventral subthalamic nucleus on emotional processing in PD patients using an affective task, compared to that of clinical-frequency stimulation and off-stimulation. METHODS Twenty PD patients with bilateral subthalamic deep brain stimulation for more than six months were tested with the affective task under three stimulation conditions (10Hz, 130Hz, and off-stimulation) in a double-blinded randomized design. RESULTS While 130Hz stimulation reduced arousal ratings in all patients, 10Hz stimulation increased arousal selectively in patients with higher depression scores. Furthermore, 10Hz stimulation induced a positive shift in valence rating to negative emotional stimuli in patients with lower apathy scores, and 130Hz stimulation led to more positive valence to emotional stimuli in the patients with higher apathy scores. Notably, we found correlational relationships between stimulation site and affective rating: arousal ratings increase with stimulation from anterior to posterior site, and positive valence ratings increase with stimulation from dorsal to ventral site of the ventral subthalamic nucleus. CONCLUSIONS Our findings highlight the distinctive role of 10Hz stimulation on subjective emotional experience and unveil the spatial organization of the stimulation effect.
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Affiliation(s)
- Linbin Wang
- Institute of Science and Technology for Brain-Inspired Intelligence (ISTBI), Fudan University, Shanghai, China; Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Li
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
| | - Yixin Pan
- 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
| | - Dianyou Li
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Valerie Voon
- Institute of Science and Technology for Brain-Inspired Intelligence (ISTBI), Fudan University, Shanghai, China; Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
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Pierce JE, Péron JA. Reward-Based Learning and Emotional Habit Formation in the Cerebellum. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1378:125-140. [DOI: 10.1007/978-3-030-99550-8_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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3
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Principles of Brain and Emotion: Beyond the Cortico-Centric Bias. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1378:13-24. [DOI: 10.1007/978-3-030-99550-8_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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4
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Pierce JE, Péron J. The basal ganglia and the cerebellum in human emotion. Soc Cogn Affect Neurosci 2021; 15:599-613. [PMID: 32507876 PMCID: PMC7328022 DOI: 10.1093/scan/nsaa076] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 04/03/2020] [Accepted: 06/02/2020] [Indexed: 12/26/2022] Open
Abstract
The basal ganglia (BG) and the cerebellum historically have been relegated to a functional role in producing or modulating motor output. Recent research, however, has emphasized the importance of these subcortical structures in multiple functional domains, including affective processes such as emotion recognition, subjective feeling elicitation and reward valuation. The pathways through the thalamus that connect the BG and cerebellum directly to each other and with extensive regions of the cortex provide a structural basis for their combined influence on limbic function. By regulating cortical oscillations to guide learning and strengthening rewarded behaviors or thought patterns to achieve a desired goal state, these regions can shape the way an individual processes emotional stimuli. This review will discuss the basic structure and function of the BG and cerebellum and propose an updated view of their functional role in human affective processing.
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Affiliation(s)
- Jordan E Pierce
- Clinical and Experimental Neuropsychology Laboratory, University of Geneva, 1205 Geneva, Switzerland
| | - Julie Péron
- Clinical and Experimental Neuropsychology Laboratory, University of Geneva, 1205 Geneva, Switzerland.,Neuropsychology Unit, Neurology Department, University Hospitals of Geneva, 1205 Geneva, Switzerland
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Mandali A, Manssuer L, Zhao Y, Zhang C, Wang L, Ding Q, Pan Y, Li D, Sun B, Voon V. Acute Time-Locked Alpha Frequency Subthalamic Stimulation Reduces Negative Emotional Bias in Parkinson's Disease. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:568-578. [PMID: 33622656 DOI: 10.1016/j.bpsc.2020.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/08/2020] [Accepted: 12/03/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Emotional processing is a core cognitive process cutting across neuropsychiatric disorders. Understanding the neurophysiological features underlying depressive symptoms and their sensitivity to modulation is critical to modifying emotional bias. The subthalamic nucleus (STN), targeted in Parkinson's disease, shows a late alpha desynchronization to affective stimuli. We targeted this alpha desynchronization using a novel stimulation protocol asking if brief alpha (10 Hz) frequency stimulation time-locked to unpleasant imagery might influence subjective emotion. METHODS A total of 27 patients with Parkinson's disease were recruited. The first study tested patients (n = 16) on affective stimuli with STN local field potential recordings assessed bilaterally without stimulation. In the second study, patients (n = 24) were tested on two affective tasks comparing negative and neutral stimuli paired with acute right-STN stimulation, with one of the negative conditions stimulated briefly for 1 second at either 130 Hz or 10 Hz. The subjects rated valence and arousal of negative and neutral stimuli. RESULTS We confirmed greater alpha desynchronization in both negative and positive affect relative to neutral in the right STN. Using acute stimulation of the right STN, we show a critical interaction effect between ratings, stimulation, and frequency; alpha frequency stimulation increased the subjective pleasantness of negative imagery, particularly with ventromedial contacts. Higher depression scores were associated with a positive bias to 10-Hz but not 130-Hz stimulation. CONCLUSIONS We highlight the potential of brief alpha frequency subthalamic stimulation to reduce negative emotional bias. This finding provides mechanistic insights underlying subjective emotional valence and has implications for the management of depression using neuromodulation.
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Affiliation(s)
- Alekhya Mandali
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Luis Manssuer
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Yijie Zhao
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Chencheng Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linbin Wang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiong Ding
- 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
| | - Dianyou Li
- 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.
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
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Palmeri R, Lo Buono V, Bonanno L, Allone C, Drago N, Sorbera C, Cimino V, di Lorenzo G, Bramanti A, Marino S. Impaired Recognition of Facial Emotion in Patients With Parkinson Disease Under Dopamine Therapy. J Geriatr Psychiatry Neurol 2020; 33:265-271. [PMID: 31635513 DOI: 10.1177/0891988719882094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Parkinson disease (PD) is a neurodegenerative disorder characterized by motor and nonmotor symptoms. The impaired ability to recognize facial emotion expressions represents an important nonmotor symptom. The aim of this study is to investigate the ability in recognizing facial emotion expressions in patients with PD under dopamine replacement therapy. METHODS Thirty medicated patients with PD and 15 healthy controls (HC) were enrolled. All participants performed the Ekman 60-Faces test for emotional recognition. All patients underwent a neuropsychological evaluation for global cognitive functioning, depression, and anxiety. RESULTS Patients with PD were impaired in recognizing emotions. Significant differences between PD and HC were found in Ekman 60-Faces test scores (P < .001), and in Ekman 60-Faces test subscales, in particular, sadness, fear, disgust, anger, and surprise (P < .001). CONCLUSIONS The nigrostriatal dopaminergic depletion seems to determine emotional information processing dysfunction. This relevant nonmotor symptom could have consequences in daily living reducing interactions and social behavioral competence.
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Affiliation(s)
| | | | - Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | - Nancy Drago
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | | | | | | | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
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Effects of Subthalamic Nucleus Deep Brain Stimulation on Facial Emotion Recognition in Parkinson's Disease: A Critical Literature Review. Behav Neurol 2020; 2020:4329297. [PMID: 32724481 PMCID: PMC7382738 DOI: 10.1155/2020/4329297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/12/2020] [Indexed: 01/04/2023] Open
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective therapy for Parkinson's disease (PD). Nevertheless, DBS has been associated with certain nonmotor, neuropsychiatric effects such as worsening of emotion recognition from facial expressions. In order to investigate facial emotion recognition (FER) after STN DBS, we conducted a literature search of the electronic databases MEDLINE and Web of science. In this review, we analyze studies assessing FER after STN DBS in PD patients and summarize the current knowledge of the effects of STN DBS on FER. The majority of studies, which had clinical and methodological heterogeneity, showed that FER is worsening after STN DBS in PD patients, particularly for negative emotions (sadness, fear, anger, and tendency for disgust). FER worsening after STN DBS can be attributed to the functional role of the STN in limbic circuits and the interference of STN stimulation with neural networks involved in FER, including the connections of the STN with the limbic part of the basal ganglia and pre- and frontal areas. These outcomes improve our understanding of the role of the STN in the integration of motor, cognitive, and emotional aspects of behaviour in the growing field of affective neuroscience. Further studies using standardized neuropsychological measures of FER assessment and including larger cohorts are needed, in order to draw definite conclusions about the effect of STN DBS on emotional recognition and its impact on patients' quality of life.
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Wagenbreth C, Kuehne M, Heinze HJ, Zaehle T. Deep Brain Stimulation of the Subthalamic Nucleus Influences Facial Emotion Recognition in Patients With Parkinson's Disease: A Review. Front Psychol 2019; 10:2638. [PMID: 31849760 PMCID: PMC6901782 DOI: 10.3389/fpsyg.2019.02638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 11/08/2019] [Indexed: 12/17/2022] Open
Abstract
Parkinson’s disease (PD) is a neurodegenerative disorder characterized by motor symptoms following dopaminergic depletion in the substantia nigra. Besides motor impairments, however, several non-motor detriments can have the potential to considerably impact subjectively perceived quality of life in patients. Particularly emotion recognition of facial expressions has been shown to be affected in PD, and especially the perception of negative emotions like fear, anger, or disgust is impaired. While emotion processing generally refers to automatic implicit as well as conscious explicit processing, the focus of most previous studies in PD was on explicit recognition of emotions only, while largely ignoring implicit processing deficits. Deep brain stimulation of the subthalamic nucleus (STN-DBS) is widely accepted as a therapeutic measure in the treatment of PD and has been shown to advantageously influence motor problems. Among various concomitant non-motor effects of STN-DBS, modulation of facial emotion recognition under subthalamic stimulation has been investigated in previous studies with rather heterogeneous results. Although there seems to be a consensus regarding the processing of disgust, which significantly deteriorates under STN stimulation, findings concerning emotions like fear or happiness report heterogeneous data and seem to depend on various experimental settings and measurements. In the present review, we summarized previous investigations focusing on STN-DBS influence on recognition of facial emotional expressions in patients suffering from PD. In a first step, we provide a synopsis of disturbances and problems in facial emotion processing observed in patients with PD. Second, we present findings of STN-DBS influence on facial emotion recognition and especially highlight different impacts of stimulation on implicit and explicit emotional processing.
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Affiliation(s)
- Caroline Wagenbreth
- Department of Neurology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Maria Kuehne
- Department of Neurology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Hans-Jochen Heinze
- Department of Neurology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Tino Zaehle
- Department of Neurology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
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Fernández-Aguilar L, Navarro-Bravo B, Ricarte J, Ros L, Latorre JM. How effective are films in inducing positive and negative emotional states? A meta-analysis. PLoS One 2019; 14:e0225040. [PMID: 31751361 PMCID: PMC6872151 DOI: 10.1371/journal.pone.0225040] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 10/27/2019] [Indexed: 12/11/2022] Open
Abstract
Meta-analyses and reviews on emotion research have shown the use of film clips to be one of the most effective methods of mood induction. Nonetheless, the effectiveness of this method when positive, negative and neutral emotional targets are studied under similar experimental conditions is currently unknown. This comprehensive meta-analysis included only studies that implemented neutral, positive and negative mood inductions to evaluate the effectiveness of the film clip method as a mood induction procedure. In addition, several factors related to the films, sample and experimental procedure used, the number of emotional categories, for example, or the number of film clips watched, were included to study their influence on the effectiveness of this mood induction procedure. Forty-five studies were included with 6675 participants and 12 possible moderator variables according to the sample and the research procedure. Our findings suggest that film clips are especially powerful in inducing negative mood states (Hedges' g for valence = -1.49 and for arousal = -1.77) although they are also effective inducers of positive mood states (Hedges' g for valence of = . -1.22 and for arousal = -1.34). Additionally, this meta-analysis reveals that variables, such as the number of emotional categories or the type of stimulus used to measure the baseline, should be considered.
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Affiliation(s)
- Luz Fernández-Aguilar
- Psychology Department, University of Castilla-La Mancha, Albacete (Spain)
- Applied Cognitive Psychology Unit, Medical School, University of Castilla La-Mancha, Albacete (Spain)
| | - Beatriz Navarro-Bravo
- Psychology Department, University of Castilla-La Mancha, Albacete (Spain)
- Applied Cognitive Psychology Unit, Medical School, University of Castilla La-Mancha, Albacete (Spain)
- Unidad de Investigación, Fundación del Hospital Nacional de Parapléjicos, Albacete (Spain)
| | - Jorge Ricarte
- Psychology Department, University of Castilla-La Mancha, Albacete (Spain)
- Applied Cognitive Psychology Unit, Medical School, University of Castilla La-Mancha, Albacete (Spain)
| | - Laura Ros
- Psychology Department, University of Castilla-La Mancha, Albacete (Spain)
- Applied Cognitive Psychology Unit, Medical School, University of Castilla La-Mancha, Albacete (Spain)
| | - Jose Miguel Latorre
- Psychology Department, University of Castilla-La Mancha, Albacete (Spain)
- Applied Cognitive Psychology Unit, Medical School, University of Castilla La-Mancha, Albacete (Spain)
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10
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Lauring JO, Pelowski M, Specker E, Ishizu T, Haugbøl S, Hollunder B, Leder H, Stender J, Kupers R. Parkinson's disease and changes in the appreciation of art: A comparison of aesthetic and formal evaluations of paintings between PD patients and healthy controls. Brain Cogn 2019; 136:103597. [PMID: 31491732 DOI: 10.1016/j.bandc.2019.103597] [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: 06/03/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 11/26/2022]
Abstract
Parkinson's disease (PD) is a progressing neurodegenerative disease predominantly involving the loss of dopamine producing neurons with hallmark symptoms of motor disorders and cognitive, motivational, emotional, and perceptual impairments. Intriguingly, PD can also be connected-often anecdotally-with a sudden burst of artistic creativity, motivation, or changed quality/style of produced art. This has led to growing empirical interest, promising a window into brain function and the unique neurological signature of artists. This topic also fits a growing interest from researchers in other areas, including Alzheimer's or other dementia, which have suggested that specific changes in art production/appraisal may provide a unique basis for therapy, diagnosis, or understanding of these diseases. However, whether PD also shows similar impacts on how we perceive and evaluate art has never been systematically addressed. We compared a cohort of PD patients against age-matched healthy controls, asking participants to rate paintings using scales of liking and beauty and terms pertaining to artworks' formal and conceptual qualities previously designed to provide a rubric for symptom identification. We found no evidence for PD-related differences in liking or beauty. However, PD patients showed higher ratings on assessed "emotionality," potentially relating to the tie between PD, dopamine pathways, and emotion/reward.
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Affiliation(s)
- Jon O Lauring
- Department of Neuroscience and Pharmacology, BRAINlab, University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen, Denmark.
| | - Matthew Pelowski
- Faculty of Psychology, Department of Basic Psychological Research and Research Methods, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria
| | - Eva Specker
- Faculty of Psychology, Department of Basic Psychological Research and Research Methods, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria
| | - Tomohiro Ishizu
- Faculty of Psychology, Department of Basic Psychological Research and Research Methods, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria; Faculty of Biosciences, Cell and Developmental Biology, University College London, Gower Street, WC1E 6BT London, UK
| | - Steven Haugbøl
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark
| | - Barbara Hollunder
- Faculty of Psychology, Department of Basic Psychological Research and Research Methods, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria
| | - Helmut Leder
- Faculty of Psychology, Department of Basic Psychological Research and Research Methods, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria
| | - Johan Stender
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, DK-2400 Copenhagen, Denmark
| | - Ron Kupers
- Department of Neuroscience and Pharmacology, BRAINlab, University of Copenhagen, Blegdamsvej 3B, DK-2200 Copenhagen, Denmark
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Deep Brain Stimulation of the Subthalamic Nucleus Selectively Modulates Emotion Recognition of Facial Stimuli in Parkinson's Patients. J Clin Med 2019; 8:jcm8091335. [PMID: 31466414 PMCID: PMC6781243 DOI: 10.3390/jcm8091335] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/23/2019] [Accepted: 08/27/2019] [Indexed: 01/05/2023] Open
Abstract
: Background: Diminished emotion recognition is a known symptom in Parkinson (PD) patients and subthalamic nucleus deep brain stimulation (STN-DBS) has been shown to further deteriorate the processing of especially negative emotions. While emotion recognition generally refers to both, implicit and explicit processing, demonstrations of DBS-influences on implicit processing are sparse. In the present study, we assessed the impact of STN-DBS on explicit and implicit processing for emotional stimuli. METHODS Under STN-DBS ON and OFF, fourteen PD patients performed an implicit as well as an explicit emotional processing task. To assess implicit emotional processing, patients were tested with a lexical decision task (LTD) combined with an affective priming paradigm, which provides emotional content through the facial eye region. To assess explicit emotional processing, patients additionally explicitly rated the emotional status of eyes and words used in the implicit task. RESULTS DBS affected explicit emotional processing more than implicit processing with a more pronounced effect on error rates than on reaction speed. STN-DBS generally worsened implicit and explicit processing for disgust stimulus material but improved explicit processing of fear stimuli. CONCLUSIONS This is the first study demonstrating influences of STN-DBS on explicit and implicit emotion processing in PD patients. While STN stimulation impeded the processing of disgust stimuli, it improved explicit discrimination of fear stimuli.
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Affective modulation of the associative-limbic subthalamic nucleus: deep brain stimulation in obsessive-compulsive disorder. Transl Psychiatry 2019; 9:73. [PMID: 30718450 PMCID: PMC6361948 DOI: 10.1038/s41398-019-0404-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 09/23/2018] [Accepted: 01/01/2019] [Indexed: 12/11/2022] Open
Abstract
Affective states underlie daily decision-making and pathological behaviours relevant to obsessive-compulsive disorders (OCD), mood disorders and addictions. Deep brain stimulation targeting the motor and associative-limbic subthalamic nucleus (STN) has been shown to be effective for Parkinson's disease (PD) and OCD, respectively. Cognitive and electrophysiological studies in PD showed responses of the motor STN to emotional stimuli, impairments in recognition of negative affective states and modulation of the intensity of subjective emotion. Here we studied whether the stimulation of the associative-limbic STN in OCD influences the subjective emotion to low-intensity positive and negative images and how this relates to clinical symptoms. We assessed 10 OCD patients with on and off STN DBS in a double-blind randomized manner by recording ratings of valence and arousal to low- and high-intensity positive and negative emotional images. STN stimulation increased positive ratings and decreased negative ratings to low-intensity positive and negative stimuli, respectively, relative to off stimulation. We also show that the change in severity of obsessive-compulsive symptoms pre- versus post-operatively interacts with both DBS and valence ratings. We show that stimulation of the associative-limbic STN might influence the negative cognitive bias in OCD and decreasing the negative appraisal of emotional stimuli with a possible relationship with clinical outcomes. That the effect is specific to low intensity might suggest a role of uncertainty or conflict related to competing interpretations of image intensity. These findings may have implications for the therapeutic efficacy of DBS.
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13
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Why would Parkinson's disease lead to sudden changes in creativity, motivation, or style with visual art?: A review of case evidence and new neurobiological, contextual, and genetic hypotheses. Neurosci Biobehav Rev 2019; 100:129-165. [PMID: 30629980 DOI: 10.1016/j.neubiorev.2018.12.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 11/15/2018] [Accepted: 12/11/2018] [Indexed: 12/13/2022]
Abstract
Parkinson's disease (PD) is a devastating diagnosis with, however, potential for an extremely intriguing aesthetic component. Despite motor and cognitive deficits, an emerging collection of studies report a burst of visual artistic output and alterations in produced art in a subgroup of patients. This provides a unique window into the neurophysiological bases for why and how we might create and enjoy visual art, as well as into general brain function and the nature of PD or other neurodegenerative diseases. However, there has not been a comprehensive organization of literature on this topic. Nor has there been an attempt to connect case evidence and knowledge on PD with present understanding of visual art making in psychology and neuroaesthetics in order to propose hypotheses for documented artistic changes. Here, we collect the current research on this topic, tie this to PD symptoms and neurobiology, and provide new theories focusing on dopaminergic neuron damage, over-stimulation from dopamine agonist therapy, and context or genetic factors revealing the neurobiological basis of the visual artistic brain.
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14
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Dondaine T, Philippot P, Batail JM, Le Jeune F, Sauleau P, Drapier S, Vérin M, Millet B, Drapier D, Robert G. Apathy alters emotional arousal in chronic schizophrenia. J Psychiatry Neurosci 2019; 44:54-61. [PMID: 30565906 PMCID: PMC6306283 DOI: 10.1503/jpn.170172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 01/10/2018] [Accepted: 05/22/2018] [Indexed: 02/01/2023] Open
Abstract
Background Within the heterogeneity of schizophrenia, apathy constitutes an independent cluster of negative symptoms associated with poor outcomes. Attempts to identify an emotional deficit in patients who have schizophrenia with negative symptoms have yielded mixed results, and studies that focus on the relationship between apathy and emotional disorders are lacking. Methods We set out to remedy this shortcoming using a validated battery of film excerpts to induce positive and negative emotions in patients with chronic schizophrenia with (n = 20) or without (n = 20) apathy, and in controls (n = 20) comparable for age, sex and socioeconomic status. We assessed emotions using an innovative but validated technique to evaluate tonic and phasic electrodermal activity and subjective feelings using a standardized visual analogue scale. Results Using a qualitative measure of apathy, we did not find a specific decrease in tonic activity during the induction of positive emotions. However, we did observe that patients with apathy showed reduced tonic activity independent of valence (i.e., for both positive and negative emotions) compared with controls and patients without apathy. Moreover, the quantitative measure of apathy (Apathy Evaluation Scale) was the only significant factor, explaining 24% of the variance in tonic activity during induction of positive emotions after controlling for confounding factors. Limitations Electrodermal activity was the only physiologic measure we acquired. We induced several emotions sequentially that might have overlapped with each other, but we added an emotional “washout” period and randomized the order of each film excerpt to limit this possibility. Conclusion Taken together, these results suggest that apathy in schizophrenia could impair tonic activity during positive emotions. Treatments aimed at enhancing positive emotions may help alleviate apathy in schizophrenia.
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Affiliation(s)
- Thibaut Dondaine
- From the University Department of Psychiatry, Guillaume Régnier Hospital, Rennes, France (Batail, D. Drapier, Robert); University of Lille, Inserm, CHU Lille, U1171, Degenerative and Vascular Cognitive Disorders, F-59000, Lille, France (Dondaine); Behaviour and Basal Ganglia Laboratory (EA 4712), University of Rennes, Rennes, France (Batail, Le Jeune, Sauleau, S. Drapier, Vérin, D. Drapier, Robert); Eugène Marquis Centre, Rennes, France (Le Jeune); Neurophysiology Department, Rennes University Hospital, Rennes, France (Sauleau); Movement Disorders Unit, Rennes University Hospital, Rennes, France (S. Drapier, Vérin); Psychiatry Department, Pitié-Salpêtrière Hospital, Paris, France (Millet); University of Louvain-la-Neuve, Louvain-la-Neuve, Belgium (Philippot)
| | - Pierre Philippot
- From the University Department of Psychiatry, Guillaume Régnier Hospital, Rennes, France (Batail, D. Drapier, Robert); University of Lille, Inserm, CHU Lille, U1171, Degenerative and Vascular Cognitive Disorders, F-59000, Lille, France (Dondaine); Behaviour and Basal Ganglia Laboratory (EA 4712), University of Rennes, Rennes, France (Batail, Le Jeune, Sauleau, S. Drapier, Vérin, D. Drapier, Robert); Eugène Marquis Centre, Rennes, France (Le Jeune); Neurophysiology Department, Rennes University Hospital, Rennes, France (Sauleau); Movement Disorders Unit, Rennes University Hospital, Rennes, France (S. Drapier, Vérin); Psychiatry Department, Pitié-Salpêtrière Hospital, Paris, France (Millet); University of Louvain-la-Neuve, Louvain-la-Neuve, Belgium (Philippot)
| | - Jean-Marie Batail
- From the University Department of Psychiatry, Guillaume Régnier Hospital, Rennes, France (Batail, D. Drapier, Robert); University of Lille, Inserm, CHU Lille, U1171, Degenerative and Vascular Cognitive Disorders, F-59000, Lille, France (Dondaine); Behaviour and Basal Ganglia Laboratory (EA 4712), University of Rennes, Rennes, France (Batail, Le Jeune, Sauleau, S. Drapier, Vérin, D. Drapier, Robert); Eugène Marquis Centre, Rennes, France (Le Jeune); Neurophysiology Department, Rennes University Hospital, Rennes, France (Sauleau); Movement Disorders Unit, Rennes University Hospital, Rennes, France (S. Drapier, Vérin); Psychiatry Department, Pitié-Salpêtrière Hospital, Paris, France (Millet); University of Louvain-la-Neuve, Louvain-la-Neuve, Belgium (Philippot)
| | - Florence Le Jeune
- From the University Department of Psychiatry, Guillaume Régnier Hospital, Rennes, France (Batail, D. Drapier, Robert); University of Lille, Inserm, CHU Lille, U1171, Degenerative and Vascular Cognitive Disorders, F-59000, Lille, France (Dondaine); Behaviour and Basal Ganglia Laboratory (EA 4712), University of Rennes, Rennes, France (Batail, Le Jeune, Sauleau, S. Drapier, Vérin, D. Drapier, Robert); Eugène Marquis Centre, Rennes, France (Le Jeune); Neurophysiology Department, Rennes University Hospital, Rennes, France (Sauleau); Movement Disorders Unit, Rennes University Hospital, Rennes, France (S. Drapier, Vérin); Psychiatry Department, Pitié-Salpêtrière Hospital, Paris, France (Millet); University of Louvain-la-Neuve, Louvain-la-Neuve, Belgium (Philippot)
| | - Paul Sauleau
- From the University Department of Psychiatry, Guillaume Régnier Hospital, Rennes, France (Batail, D. Drapier, Robert); University of Lille, Inserm, CHU Lille, U1171, Degenerative and Vascular Cognitive Disorders, F-59000, Lille, France (Dondaine); Behaviour and Basal Ganglia Laboratory (EA 4712), University of Rennes, Rennes, France (Batail, Le Jeune, Sauleau, S. Drapier, Vérin, D. Drapier, Robert); Eugène Marquis Centre, Rennes, France (Le Jeune); Neurophysiology Department, Rennes University Hospital, Rennes, France (Sauleau); Movement Disorders Unit, Rennes University Hospital, Rennes, France (S. Drapier, Vérin); Psychiatry Department, Pitié-Salpêtrière Hospital, Paris, France (Millet); University of Louvain-la-Neuve, Louvain-la-Neuve, Belgium (Philippot)
| | - Sophie Drapier
- From the University Department of Psychiatry, Guillaume Régnier Hospital, Rennes, France (Batail, D. Drapier, Robert); University of Lille, Inserm, CHU Lille, U1171, Degenerative and Vascular Cognitive Disorders, F-59000, Lille, France (Dondaine); Behaviour and Basal Ganglia Laboratory (EA 4712), University of Rennes, Rennes, France (Batail, Le Jeune, Sauleau, S. Drapier, Vérin, D. Drapier, Robert); Eugène Marquis Centre, Rennes, France (Le Jeune); Neurophysiology Department, Rennes University Hospital, Rennes, France (Sauleau); Movement Disorders Unit, Rennes University Hospital, Rennes, France (S. Drapier, Vérin); Psychiatry Department, Pitié-Salpêtrière Hospital, Paris, France (Millet); University of Louvain-la-Neuve, Louvain-la-Neuve, Belgium (Philippot)
| | - Marc Vérin
- From the University Department of Psychiatry, Guillaume Régnier Hospital, Rennes, France (Batail, D. Drapier, Robert); University of Lille, Inserm, CHU Lille, U1171, Degenerative and Vascular Cognitive Disorders, F-59000, Lille, France (Dondaine); Behaviour and Basal Ganglia Laboratory (EA 4712), University of Rennes, Rennes, France (Batail, Le Jeune, Sauleau, S. Drapier, Vérin, D. Drapier, Robert); Eugène Marquis Centre, Rennes, France (Le Jeune); Neurophysiology Department, Rennes University Hospital, Rennes, France (Sauleau); Movement Disorders Unit, Rennes University Hospital, Rennes, France (S. Drapier, Vérin); Psychiatry Department, Pitié-Salpêtrière Hospital, Paris, France (Millet); University of Louvain-la-Neuve, Louvain-la-Neuve, Belgium (Philippot)
| | - Bruno Millet
- From the University Department of Psychiatry, Guillaume Régnier Hospital, Rennes, France (Batail, D. Drapier, Robert); University of Lille, Inserm, CHU Lille, U1171, Degenerative and Vascular Cognitive Disorders, F-59000, Lille, France (Dondaine); Behaviour and Basal Ganglia Laboratory (EA 4712), University of Rennes, Rennes, France (Batail, Le Jeune, Sauleau, S. Drapier, Vérin, D. Drapier, Robert); Eugène Marquis Centre, Rennes, France (Le Jeune); Neurophysiology Department, Rennes University Hospital, Rennes, France (Sauleau); Movement Disorders Unit, Rennes University Hospital, Rennes, France (S. Drapier, Vérin); Psychiatry Department, Pitié-Salpêtrière Hospital, Paris, France (Millet); University of Louvain-la-Neuve, Louvain-la-Neuve, Belgium (Philippot)
| | - Dominique Drapier
- From the University Department of Psychiatry, Guillaume Régnier Hospital, Rennes, France (Batail, D. Drapier, Robert); University of Lille, Inserm, CHU Lille, U1171, Degenerative and Vascular Cognitive Disorders, F-59000, Lille, France (Dondaine); Behaviour and Basal Ganglia Laboratory (EA 4712), University of Rennes, Rennes, France (Batail, Le Jeune, Sauleau, S. Drapier, Vérin, D. Drapier, Robert); Eugène Marquis Centre, Rennes, France (Le Jeune); Neurophysiology Department, Rennes University Hospital, Rennes, France (Sauleau); Movement Disorders Unit, Rennes University Hospital, Rennes, France (S. Drapier, Vérin); Psychiatry Department, Pitié-Salpêtrière Hospital, Paris, France (Millet); University of Louvain-la-Neuve, Louvain-la-Neuve, Belgium (Philippot)
| | - Gabriel Robert
- From the University Department of Psychiatry, Guillaume Régnier Hospital, Rennes, France (Batail, D. Drapier, Robert); University of Lille, Inserm, CHU Lille, U1171, Degenerative and Vascular Cognitive Disorders, F-59000, Lille, France (Dondaine); Behaviour and Basal Ganglia Laboratory (EA 4712), University of Rennes, Rennes, France (Batail, Le Jeune, Sauleau, S. Drapier, Vérin, D. Drapier, Robert); Eugène Marquis Centre, Rennes, France (Le Jeune); Neurophysiology Department, Rennes University Hospital, Rennes, France (Sauleau); Movement Disorders Unit, Rennes University Hospital, Rennes, France (S. Drapier, Vérin); Psychiatry Department, Pitié-Salpêtrière Hospital, Paris, France (Millet); University of Louvain-la-Neuve, Louvain-la-Neuve, Belgium (Philippot)
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15
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Martínez-Fernández R, Kibleur A, Chabardès S, Fraix V, Castrioto A, Lhommée E, Moro E, Lescoules L, Pelissier P, David O, Krack P. Different effects of levodopa and subthalamic stimulation on emotional conflict in Parkinson's disease. Hum Brain Mapp 2018; 39:5014-5027. [PMID: 30259598 DOI: 10.1002/hbm.24341] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 07/02/2018] [Accepted: 07/22/2018] [Indexed: 12/17/2022] Open
Abstract
Parkinson's disease impairs the decoding of emotional stimuli reflecting alterations of the limbic cortico-subcortical network. The objective of this study was to assess and compare the behavioral and electrophysiological effects of both levodopa and subthalamic stimulation on emotional processing in Parkinson's disease. Operated patients (n =16) and matched healthy subjects performed an emotional Stroop task, in which the emotion expressed by a face must be recognized while ignoring an emotional distractive word and that includes a neutral control sub-task. Patients were tested in the four possible treatment conditions (off stim/off med; on stim/off med; off stim/on med; and on stim/on med). High-resolution electroencephalography was recorded while performing the task. Patients made significantly more mistakes in facial emotion recognition than healthy subjects (p < .005). Untreated patients performed worse in the emotional trials than in the control sub-task (p < .05). Fearful faces induced significantly slower reaction times than happy faces in patients (p = .0002), but not in the healthy subjects. The emotional Stroop effect with levodopa was significantly higher than with subthalamic stimulation when fearful faces were assessed (p = .0243). Conversely, treatments did not modulate the Stroop effect of the control sub-task. EEG demonstrated that, compared with the untreated state, levodopa but not subthalamic stimulation significantly increases the amplitude of the event-related potential N170 (p = .002 vs. p = .1, respectively), an electrophysiological biomarker of early aspects of facial processing. The activity of the N170 cortical sources within the right fusiform gyrus was increased by levodopa (p < .05) but not by stimulation. While levodopa normalizes the recognition of emotional facial expression and early EEG markers of emotional processing, subthalamic stimulation does not. Thus, operated patients require dopaminergic medication in addition to stimulation to treat emotional symptoms of Parkinson's disease.
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Affiliation(s)
- Raul Martínez-Fernández
- CINAC-Hospital Universitario HM Puerta del Sur, Móstoles, Universidad CEU San Pablo, Madrid, Spain.,Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Astrid Kibleur
- U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Stéphan Chabardès
- U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France.,Neurosurgery Department, CHU Grenoble Alpes, Grenoble, France
| | - Valérie Fraix
- Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Anna Castrioto
- Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Eugénie Lhommée
- Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Elena Moro
- Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Lucas Lescoules
- U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Pierre Pelissier
- Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Olivier David
- U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France
| | - Paul Krack
- Movement Disorders Unit, CHU Grenoble Alpes, Grenoble, France.,U1216, Grenoble Institut des Neurosciences, Inserm, Université Grenoble Alpes, Grenoble, France.,Neurosurgery Department, CHU Grenoble Alpes, Grenoble, France.,Division of Neurology, Department of Neuroscience, Geneva University Hospitals, Geneva, Switzerland
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16
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Trost W, Leh F, Houvenaghel JF, Choppin S, Drapier S, Sauleau P, Haegelen C, Robert G, Grandjean D, Vérin M. Subthalamic deep brain stimulation influences complex emotional musical experience in Parkinson's disease. Neuropsychologia 2018; 117:278-286. [PMID: 29936120 DOI: 10.1016/j.neuropsychologia.2018.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 06/11/2018] [Accepted: 06/20/2018] [Indexed: 11/27/2022]
Abstract
Subthalamic deep brain stimulation (STN DBS) is an effective treatment for reducing the motor symptoms of patients with Parkinson's disease (PD), but several side effects have been reported, concerning the processing of emotions. Music has been shown to evoke powerful emotional experiences - not only basic emotions, but also complex, so-called aesthetic experiences. The goal of the present study was therefore to investigate how STN DBS influences the experience of both basic and more complex musical emotions in patients with PD. In a three-group between-participants design, we compared healthy controls (HC), patients receiving STN DBS (PD-DBS), and patients who were candidates for STN DBS and receiving medication only (PD-MO) on their assessments of subjectively experienced musical emotions. Results showed that in general, the experience of musical emotions differed only marginally between the PD-MO, PD-DBS, and HC groups. Nonetheless, we were able to discern subtle but distinct effects of PD and STN DBS in the emotional responses. Happy music, for instance, seemed to induce a heightened experience of negative emotions (tension) in PD-MO patients. STN DBS appeared to normalize this particular effect, but increased nostalgic feelings - a rather complex affective experience - in response to the same emotional stimuli. This should not be taken as indicating a bias for nostalgia in the PD-DBS subgroup, as these patients found music inducing melancholy to be less nostalgic and more joyful than HC did. In conclusion, our study showed that music elicits slightly altered emotional experiences in patients with and without STN DBS. In particular, STN DBS seems to induce less distinct emotional responses, blurring the boundaries between complex musical emotions.
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Affiliation(s)
- W Trost
- Neurosciences of Emotions and Affective Dynamics Laboratory, Department of Psychology, University of Geneva, Switzerland; Swiss Centre for Affective Sciences, University of Geneva, Switzerland.
| | - F Leh
- Neurology Department, Rennes University Hospital, Rennes, France.
| | - J-F Houvenaghel
- Neurology Department, Rennes University Hospital, Rennes, France
| | - S Choppin
- University Centre of Excellence in Psychiatry, Albert Chenevier Hospital, Créteil, France
| | - S Drapier
- Neurology Department, Rennes University Hospital, Rennes, France
| | - P Sauleau
- Neurology Department, Rennes University Hospital, Rennes, France
| | - C Haegelen
- Neurology Department, Rennes University Hospital, Rennes, France
| | - G Robert
- Neurology Department, Rennes University Hospital, Rennes, France
| | - D Grandjean
- Neurosciences of Emotions and Affective Dynamics Laboratory, Department of Psychology, University of Geneva, Switzerland; Swiss Centre for Affective Sciences, University of Geneva, Switzerland
| | - M Vérin
- Neurology Department, Rennes University Hospital, Rennes, France
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17
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Bick SKB, Folley BS, Mayer JS, Park S, Charles PD, Camalier CR, Pallavaram S, Konrad PE, Neimat JS. Subthalamic Nucleus Deep Brain Stimulation Alters Prefrontal Correlates of Emotion Induction. Neuromodulation 2016; 20:233-237. [PMID: 27730703 DOI: 10.1111/ner.12537] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/08/2016] [Accepted: 09/13/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves motor symptoms in advanced Parkinson's disease. STN DBS may also affect emotion, possibly by impacting a parallel limbic cortico-striatal circuit. The objective of this study was to investigate changes in prefrontal cortical activity related to DBS during an emotion induction task. MATERIALS AND METHODS We used near infrared spectroscopy to monitor prefrontal cortex hemodynamic changes during an emotion induction task. Seven DBS patients were tested sequentially in the stimulation-on and stimulation-off states while on dopaminergic medication. Patients watched a series of positive, negative, and neutral videos. The general linear model was used to compare prefrontal oxygenated hemoglobin concentration between DBS states. RESULTS Deep brain stimulation was correlated with prefrontal oxygenated hemoglobin changes relative to the stimulation off state in response to both positive and negative videos. These changes were specific to emotional stimuli and were not seen during neutral stimuli. CONCLUSIONS These results suggest that STN stimulation influences the prefrontal cortical representation of positive and negative emotion induction.
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Affiliation(s)
- Sarah K B Bick
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Bradley S Folley
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA.,Norton Neuroscience Institute, Louisville, KY, USA
| | - Jutta S Mayer
- Department of Psychology, Vanderbilt University, Nashville, TN, USA.,Department of Psychology, University of Frankfurt, Frankfurt, Germany
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - P David Charles
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Corrie R Camalier
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Srivatsan Pallavaram
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Peter E Konrad
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Joseph S Neimat
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
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18
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Ory S, Le Jeune F, Haegelen C, Vicente S, Philippot P, Dondaine T, Jannin P, Drapier S, Drapier D, Sauleau P, Vérin M, Péron J. Pre-frontal-insular-cerebellar modifications correlate with disgust feeling blunting after subthalamic stimulation: A positron emission tomography study in Parkinson's disease. J Neuropsychol 2015; 11:378-395. [PMID: 26670087 DOI: 10.1111/jnp.12094] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Revised: 10/26/2015] [Indexed: 12/01/2022]
Abstract
Subthalamic nucleus (STN) deep brain stimulation (DBS) has recently advanced our understanding of the major role played by this basal ganglion in human emotion. Research indicates that STN DBS can induce modifications in all components of emotion, and neuroimaging studies have shown that the metabolic modifications correlated with these emotional disturbances following surgery are both task- and sensory input-dependent. Nevertheless, to date, these modifications have not been confirmed for all emotional components, notably subjective emotional experience, or feelings. To identify the neural network underlying the modification of feelings following STN DBS, we assessed 16 patients with Parkinson's disease before and after surgery, using both subjective assessments of emotional experience and 18 [F]fluorodeoxyglucose positron emission tomography (18 FDG-PET). The patients viewed six film excerpts intended to elicit happy, angry, fearful, sad, disgusted, and neutral feelings, and they self-rated the intensity of these feelings. After DBS, there was a significant reduction in the intensity of the disgust feeling. Correlations were observed between decreased disgust experience and cerebral glucose metabolism (FDG uptake) in the bilateral pre-frontal cortices (orbitofrontal, dorsolateral, and inferior frontal gyri), bilateral insula, and right cerebellum. We suggest that the STN contributes to the synchronization process underlying the emergence of feelings.
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Affiliation(s)
- Sophie Ory
- 'Behaviour and Basal Ganglia' Research Unit, University of Rennes 1, Rennes University Hospital, France.,Neurology Department, Rennes University Hospital, France
| | - Florence Le Jeune
- 'Behaviour and Basal Ganglia' Research Unit, University of Rennes 1, Rennes University Hospital, France.,Nuclear Medicine Department, Eugène Marquis Centre, Rennes, France
| | - Claire Haegelen
- MediCIS, INSERM, Faculty of Medicine, University of Rennes I, France.,Neurosurgery Department, Rennes University Hospital, France
| | - Siobhan Vicente
- UMR CNRS 7295, Centre for Research on Cognition and Learning, Poitiers, France
| | - Pierre Philippot
- Department of Psychology, University of Louvain-La-Neuve, Belgium
| | - Thibaut Dondaine
- 'Behaviour and Basal Ganglia' Research Unit, University of Rennes 1, Rennes University Hospital, France
| | - Pierre Jannin
- MediCIS, INSERM, Faculty of Medicine, University of Rennes I, France
| | - Sophie Drapier
- 'Behaviour and Basal Ganglia' Research Unit, University of Rennes 1, Rennes University Hospital, France.,Neurology Department, Rennes University Hospital, France
| | - Dominique Drapier
- 'Behaviour and Basal Ganglia' Research Unit, University of Rennes 1, Rennes University Hospital, France.,Adult Psychiatry Department, Guillaume Régnier Hospital, Rennes, France
| | - Paul Sauleau
- 'Behaviour and Basal Ganglia' Research Unit, University of Rennes 1, Rennes University Hospital, France.,Physiology Department, Rennes University Hospital, France
| | - Marc Vérin
- 'Behaviour and Basal Ganglia' Research Unit, University of Rennes 1, Rennes University Hospital, France.,Neurology Department, Rennes University Hospital, France
| | - Julie Péron
- 'Neuroscience of Emotion and Affective Dynamics' Laboratory, Department of Psychology and Swiss Centre for Affective Sciences, University of Geneva, Switzerland
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19
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A fronto–striato–subthalamic–pallidal network for goal-directed and habitual inhibition. Nat Rev Neurosci 2015; 16:719-32. [DOI: 10.1038/nrn4038] [Citation(s) in RCA: 352] [Impact Index Per Article: 39.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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20
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Sensory contribution to vocal emotion deficit in Parkinson's disease after subthalamic stimulation. Cortex 2014; 63:172-83. [PMID: 25282055 DOI: 10.1016/j.cortex.2014.08.023] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 07/20/2014] [Accepted: 08/23/2014] [Indexed: 11/21/2022]
Abstract
Subthalamic nucleus (STN) deep brain stimulation in Parkinson's disease induces modifications in the recognition of emotion from voices (or emotional prosody). Nevertheless, the underlying mechanisms are still only poorly understood, and the role of acoustic features in these deficits has yet to be elucidated. Our aim was to identify the influence of acoustic features on changes in emotional prosody recognition following STN stimulation in Parkinson's disease. To this end, we analysed the performances of patients on vocal emotion recognition in pre-versus post-operative groups, as well as of matched controls, entering the acoustic features of the stimuli into our statistical models. Analyses revealed that the post-operative biased ratings on the Fear scale when patients listened to happy stimuli were correlated with loudness, while the biased ratings on the Sadness scale when they listened to happiness were correlated with fundamental frequency (F0). Furthermore, disturbed ratings on the Happiness scale when the post-operative patients listened to sadness were found to be correlated with F0. These results suggest that inadequate use of acoustic features following subthalamic stimulation has a significant impact on emotional prosody recognition in patients with Parkinson's disease, affecting the extraction and integration of acoustic cues during emotion perception.
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21
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Aiello M, Eleopra R, Lettieri C, Mondani M, D'Auria S, Belgrado E, Piani A, De Simone L, Rinaldo S, Rumiati RI. Emotion recognition in Parkinson's disease after subthalamic deep brain stimulation: Differential effects of microlesion and STN stimulation. Cortex 2014; 51:35-45. [DOI: 10.1016/j.cortex.2013.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 09/25/2013] [Accepted: 11/08/2013] [Indexed: 12/19/2022]
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22
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Buot A, Welter ML, Karachi C, Pochon JB, Bardinet E, Yelnik J, Mallet L. Processing of emotional information in the human subthalamic nucleus. J Neurol Neurosurg Psychiatry 2013; 84:1331-8. [PMID: 23100448 DOI: 10.1136/jnnp-2011-302158] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The subthalamic nucleus (STN) is an efficient target for treating patients with Parkinson's disease as well as patients with obsessive-compulsive disorder (OCD) using high frequency stimulation (HFS). In both Parkinson's disease and OCD patients, STN-HFS can trigger abnormal behaviours, such as hypomania and impulsivity. METHODS To investigate if this structure processes emotional information, and whether it depends on motor demands, we recorded subthalamic local field potentials in 16 patients with Parkinson's disease using deep brain stimulation electrodes. Recordings were made with and without dopaminergic treatment while patients performed an emotional categorisation paradigm in which the response varied according to stimulus valence (pleasant, unpleasant and neutral) and to the instruction given (motor, non-motor and passive). RESULTS Pleasant, unpleasant and neutral stimuli evoked an event related potential (ERP). Without dopamine medication, ERP amplitudes were significantly larger for unpleasant compared with neutral pictures, whatever the response triggered by the stimuli; and the magnitude of this effect was maximal in the ventral part of the STN. No significant difference in ERP amplitude was observed for pleasant pictures. With dopamine medication, ERP amplitudes were significantly increased for pleasant compared with neutral pictures whatever the response triggered by the stimuli, while ERP amplitudes to unpleasant pictures were not modified. CONCLUSIONS These results demonstrate that the ventral part of the STN processes the emotional valence of stimuli independently of the motor context and that dopamine enhances processing of pleasant information. These findings confirm the specific involvement of the STN in emotional processes in human, which may underlie the behavioural changes observed in patients with deep brain stimulation.
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Affiliation(s)
- Anne Buot
- Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière (CRICM), Université Pierre et Marie Curie-Paris 6, Paris, France
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23
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Eitan R, Shamir RR, Linetsky E, Rosenbluh O, Moshel S, Ben-Hur T, Bergman H, Israel Z. Asymmetric right/left encoding of emotions in the human subthalamic nucleus. Front Syst Neurosci 2013; 7:69. [PMID: 24194703 PMCID: PMC3810611 DOI: 10.3389/fnsys.2013.00069] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/04/2013] [Indexed: 01/13/2023] Open
Abstract
Emotional processing is lateralized to the non-dominant brain hemisphere. However, there is no clear spatial model for lateralization of emotional domains in the basal ganglia. The subthalamic nucleus (STN), an input structure in the basal ganglia network, plays a major role in the pathophysiology of Parkinson's disease (PD). This role is probably not limited only to the motor deficits of PD, but may also span the emotional and cognitive deficits commonly observed in PD patients. Beta oscillations (12–30 Hz), the electrophysiological signature of PD, are restricted to the dorsolateral part of the STN that corresponds to the anatomically defined sensorimotor STN. The more medial, more anterior and more ventral parts of the STN are thought to correspond to the anatomically defined limbic and associative territories of the STN. Surprisingly, little is known about the electrophysiological properties of the non-motor domains of the STN, nor about electrophysiological differences between right and left STNs. In this study, microelectrodes were utilized to record the STN spontaneous spiking activity and responses to vocal non-verbal emotional stimuli during deep brain stimulation (DBS) surgeries in human PD patients. The oscillation properties of the STN neurons were used to map the dorsal oscillatory and the ventral non-oscillatory regions of the STN. Emotive auditory stimulation evoked activity in the ventral non-oscillatory region of the right STN. These responses were not observed in the left ventral STN or in the dorsal regions of either the right or left STN. Therefore, our results suggest that the ventral non-oscillatory regions are asymmetrically associated with non-motor functions, with the right ventral STN associated with emotional processing. These results suggest that DBS of the right ventral STN may be associated with beneficial or adverse emotional effects observed in PD patients and may relieve mental symptoms in other neurological and psychiatric diseases.
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Affiliation(s)
- Renana Eitan
- Department of Psychiatry, Hadassah-Hebrew University Medical Center Jerusalem, Israel
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STN-DBS does not change emotion recognition in advanced Parkinson's disease. Parkinsonism Relat Disord 2013; 20:166-9. [PMID: 24182523 DOI: 10.1016/j.parkreldis.2013.10.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 09/07/2013] [Accepted: 10/09/2013] [Indexed: 11/23/2022]
Abstract
UNLABELLED Deep brain stimulation of the subthalamic nuclei (STN-DBS) for the treatment of levodopa-induced motor complications in advanced Parkinson's disease (APD) has been associated with neuropsychiatric disorders. It has been suggested that a postoperative decline in visual emotion recognition is responsible for those adverse events, although there is also evidence that emotional processing deficits can be present before surgery. The aim of the present study is to compare the ability to recognize emotions before and one year after surgery in APD. METHODS Consecutively operated APD patients were tested pre-operatively and one year after STN-DBS by the Comprehensive Affect Testing System (CATS), which evaluates visual recognition of 7 basic emotions (happiness, sadness, anger, fear, surprise, disgust and neutral) on facial expressions and 4 emotions on prosody (happiness, sadness, anger and fear). RESULTS In a sample of 30 patients 6 had depression or apathy at baseline that significantly increased to 14 post-surgery. There were no significant changes in the tests of identity discrimination, discrimination of emotional faces, naming of emotional faces, recognition of emotional prosody, and naming of emotional prosody after STN-DBS. The results of emotion tests could not predict the development of the neuropsychiatric symptoms. DISCUSSION This study does not support the hypothesis of an acquired change in emotion recognition, either in faces or in prosody, after STN-DBS in APD patients. Neuropsychiatric symptoms appearing after STN-DBS should not be attributed to new deficits in emotional recognition.
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Reymann JM, Naudet F, Pihan M, Saïkali S, Laviolle B, Bentué-Ferrer D. Subthalamic nucleus modulates social and anxogenic-like behaviors. Behav Brain Res 2013; 252:356-62. [PMID: 23748197 DOI: 10.1016/j.bbr.2013.05.059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 05/24/2013] [Accepted: 05/28/2013] [Indexed: 01/07/2023]
Abstract
In Parkinson's disease, global social maladjustment and anxiety are frequent after subthalamic nucleus (STN) stimulation and are generally considered to be linked with sociofamilial alterations induced by the motor effects of stimulation. We hypothesized that the STN is per se involved in these changes and aimed to explore the role of STN in social and anxogenic-like behaviors using an animal model. Nineteen male Wistar rats with bilateral lesions of the STN were compared with 26 sham-lesioned rats by synchronizing an ethological approach based upon direct observation of social behaviors and a standardized approach, the elevated plus maze (EPM). Comparisons between groups were performed by a Mann-Whitney-Wilcoxon test. Lesioned rats showed impairments in their social (P=0.05) and aggressive behaviors with a diminution of attacking (P=0.04) and chasing (P=0.06). In the EPM, concerning the open arms, the percentage of distance, time, inactive time, and entry were significantly decreased in lesioned rats (P=0.02, P=0.01, P=0.04, and P=0.05). The time spent in non-protected head dips was also diminished in the lesioned rats (P=0.01). These results strongly implicate the STN in social behavior and anxogenic-like behavior. In human, as DBS induces changes in the underlying dynamics of the stimulated brain networks, it could create an abnormal brain state in which anxiety and social behavior are altered. These results highlight another level of complexity of the behavioral changes after stimulation.
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Affiliation(s)
- Jean-Michel Reymann
- Université de Rennes 1, Laboratoire de Pharmacologie Expérimentale et Clinique, Faculté de Médecine, France
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Péron J, Frühholz S, Vérin M, Grandjean D. Subthalamic nucleus: a key structure for emotional component synchronization in humans. Neurosci Biobehav Rev 2013; 37:358-73. [PMID: 23318227 DOI: 10.1016/j.neubiorev.2013.01.001] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Revised: 12/12/2012] [Accepted: 01/03/2013] [Indexed: 11/28/2022]
Abstract
Affective neuroscience is concerned with identifying the neural bases of emotion. For historical and methodological reasons, models describing the brain architecture that supports emotional processes in humans have tended to neglect the basal ganglia, focusing instead on cortical and amygdalar mechanisms. Now, however, deep brain stimulation (DBS) of the subthalamic nucleus (STN), a neurosurgical treatment for Parkinson's disease and obsessive-compulsive disorder, is helping researchers explore the possible functional role of this particular basal ganglion in emotional processes. After reviewing studies that have used DBS in this way, we propose a model in which the STN plays a crucial role in producing temporally organized neural co-activation patterns at the cortical and subcortical levels that are essential for generating emotions and related feelings.
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Affiliation(s)
- Julie Péron
- Swiss Center for Affective Sciences, 7 rue des Battoirs, 1205 Geneva, Switzerland.
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Mondillon L, Mermillod M, Musca SC, Rieu I, Vidal T, Chambres P, Auxiette C, Dalens H, Marie Coulangeon L, Jalenques I, Lemaire JJ, Ulla M, Derost P, Marques A, Durif F. The combined effect of subthalamic nuclei deep brain stimulation and L-dopa increases emotion recognition in Parkinson's disease. Neuropsychologia 2012; 50:2869-2879. [PMID: 22944002 DOI: 10.1016/j.neuropsychologia.2012.08.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 07/17/2012] [Accepted: 08/19/2012] [Indexed: 11/28/2022]
Abstract
Deep brain stimulation of the subthalamic nucleus (DBS) is a widely used surgical technique to suppress motor symptoms in Parkinson's disease (PD), and as such improves patients' quality of life. However, DBS may produce emotional disorders such as a reduced ability to recognize emotional facial expressions (EFE). Previous studies have not considered the fact that DBS and l-dopa medication can have differential, common, or complementary consequences on EFE processing. A thorough way of investigating the effect of DBS and l-dopa medication in greater detail is to compare patients' performances after surgery, with the two therapies either being administered ('on') or not administered ('off'). We therefore used a four-condition (l-dopa 'on'/DBS 'on', l-dopa 'on'/DBS 'off', l-dopa 'off'/DBS 'on', and l-dopa 'off'/DBS 'off') EFE recognition paradigm and compared implanted PD patients to healthy controls. The results confirmed those of previous studies, yielding a significant impairment in the detection of some facial expressions relative to controls. Disgust recognition was impaired when patients were 'off' l-dopa and 'on' DBS, and fear recognition impaired when 'off' of both therapies. More interestingly, the combined effect of both DBS and l-dopa administration seems much more beneficial for EFE recognition than the separate administration of each individual therapy. We discuss the implications of these findings in the light of the inverted U curve function that describes the differential effects of dopamine level on the right orbitofrontal cortex (OFC). We propose that, while l-dopa could "overdose" in dopamine the ventral stream of the OFC, DBS would compensate for this over-activation by decreasing OFC activity, thereby restoring the necessary OFC-amygdala interaction. Another finding is that, when collapsing over all treatment conditions, PD patients recognized more neutral faces than the matched controls, a result that concurs with embodiment theories.
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Affiliation(s)
- Laurie Mondillon
- LAPSCO (UMR 6024), Blaise Pascal University, Clermont-Ferrand 63000, France.
| | - Martial Mermillod
- LAPSCO (UMR 6024), Blaise Pascal University, Clermont-Ferrand 63000, France; Institut Universitaire de France, Paris 75005, France
| | - Serban C Musca
- CRPCC (EA 1285), European University of Brittany, Rennes 35000, France
| | - Isabelle Rieu
- Neurology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France; UFR Medecine, University of Clermont 1, Clermont-Ferrand F-63009, France
| | - Tiphaine Vidal
- Neurology Department, Resource and Research Memory Center (CMRR), CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | - Patrick Chambres
- LAPSCO (UMR 6024), Blaise Pascal University, Clermont-Ferrand 63000, France
| | - Catherine Auxiette
- Neurology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | - Hélène Dalens
- Ophtalmology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | | | - Isabelle Jalenques
- UFR Medecine, University of Clermont 1, Clermont-Ferrand F-63009, France; Psychiatry A Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | - Jean-Jacques Lemaire
- UFR Medecine, University of Clermont 1, Clermont-Ferrand F-63009, France; Neurosurgery Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | - Miguel Ulla
- Neurology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | - Philippe Derost
- Neurology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France
| | - Ana Marques
- Neurology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France; UFR Medecine, University of Clermont 1, Clermont-Ferrand F-63009, France
| | - Franck Durif
- Neurology Department, CHU Clermont-Ferrand, Clermont-Ferrand F-63001, France; UFR Medecine, University of Clermont 1, Clermont-Ferrand F-63009, France
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Péron J, Dondaine T. [Emotion and basal ganglia (II): what can we learn from subthalamic nucleus deep brain stimulation in Parkinson's disease?]. Rev Neurol (Paris) 2012; 168:642-8. [PMID: 22901366 DOI: 10.1016/j.neurol.2012.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 06/18/2012] [Accepted: 06/20/2012] [Indexed: 11/16/2022]
Abstract
The subthalamic nucleus deep-brain stimulation Parkinson's disease patient model seems to represent a unique opportunity for studying the functional role of the basal ganglia and notably the subthalamic nucleus in human emotional processing. Indeed, in addition to constituting a therapeutic advance for severely disabled Parkinson's disease patients, deep brain stimulation is a technique, which selectively modulates the activity of focal structures targeted by surgery. There is growing evidence of a link between emotional impairments and deep-brain stimulation of the subthalamic nucleus. In this context, according to the definition of emotional processing exposed in the companion paper available in this issue, the aim of the present review will consist in providing a synopsis of the studies that investigated the emotional disturbances observed in subthalamic nucleus deep brain stimulation Parkinson's disease patients. This review leads to the conclusion that several emotional components would be disrupted after subthalamic nucleus deep brain stimulation in Parkinson's disease: subjective feeling, neurophysiological activation, and motor expression. Finally, after a description of the limitations of this study model, we discuss the functional role of the subthalamic nucleus (and the striato-thalamo-cortical circuits in which it is involved) in emotional processing. It seems reasonable to conclude that the striato-thalamo-cortical circuits are indeed involved in emotional processing and that the subthalamic nucleus plays a central in role the human emotional architecture.
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Affiliation(s)
- J Péron
- EA 4712 « behavior and basal ganglia », université Rennes 1, 2, Rennes, France
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Bernal-Pacheco O, Oyama G, Foote KD, Dai YE, Wu SS, Jacobson CE, Limotai N, Zeilman PR, Romrell J, Hwynn N, Rodriguez RL, Malaty IA, Okun MS. Taking a better history for behavioral issues pre- and post-deep brain stimulation: issues missed by standardized scales. Neuromodulation 2012; 16:35-9; discussion 39-40. [PMID: 22748071 DOI: 10.1111/j.1525-1403.2012.00477.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To screen for potentially underreported behavioral changes in patients with idiopathic Parkinson's disease (PD) pre- and post-deep brain stimulation (DBS), a retrospective data base review was performed. METHODS In total, 113 patients who underwent unilateral or bilateral DBS at the University of Florida in either subthalamic nucleus or globus pallidus internus for PD were screened for behavioral issues by asking about the presence or absence of seven neuropsychiatric symptoms (panic, fear, paranoia, anger, suicidal flashes, crying, and laughing). RESULTS There was a high prevalence of fear (16.3%), panic (14.0%), and anger (11.6%) at baseline in this cohort. In the first six months following DBS implantation, anger (32.6%), fear (26.7%), and uncontrollable crying (26.7%) were the most frequent symptoms reported. Those symptoms also were present following six months of DBS surgery (30.2%, 29.1%, and 19.8%, respectively). New uncontrollable crying occurred more in the acute postoperative stage (less than or equal to six months) (p = 0.033), while new anger occurred more in the chronic postoperative stage (greater than six months) (p = 0.017). The frequency of uncontrollable laughing significantly increased with bilateral DBS (p = 0.033). CONCLUSIONS Many of the neuropsychiatric issues were identified at preoperative baseline and their overall occurrence was more than expected. There was a potential for worsening of these issues post-DBS. There were subtle differences in time course, and in unilateral vs. bilateral implantations. Clinicians should be aware of these potential behavioral issues that may emerge following DBS therapy, and should consider including screening questions in preoperative and postoperative interviews. Standardized scales may miss the presence or absence of these clinically relevant issues.
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Affiliation(s)
- Oscar Bernal-Pacheco
- Departments of Neurology Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA
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Baunez C, Yelnik J, Mallet L. Six questions on the subthalamic nucleus: lessons from animal models and from stimulated patients. Neuroscience 2011; 198:193-204. [PMID: 22001680 DOI: 10.1016/j.neuroscience.2011.09.059] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 09/22/2011] [Accepted: 09/26/2011] [Indexed: 01/08/2023]
Affiliation(s)
- C Baunez
- Laboratoire de Neurobiologie de la Cognition-LNC, UMR6155 Centre National de la Recherche Scientifique-CNRS, 3 Place Victor Hugo, F-13000 Marseille, France.
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Serranová T, Jech R, Dušek P, Sieger T, Růžička F, Urgošík D, Růžička E. Subthalamic nucleus stimulation affects incentive salience attribution in Parkinson's disease. Mov Disord 2011; 26:2260-6. [PMID: 21780183 DOI: 10.1002/mds.23880] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2010] [Revised: 04/04/2011] [Accepted: 05/09/2011] [Indexed: 11/10/2022] Open
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) can induce nonmotor side effects such as behavioral and mood disturbances or body weight gain in Parkinson's disease (PD) patients. We hypothesized that some of these problems could be related to an altered attribution of incentive salience (ie, emotional relevance) to rewarding and aversive stimuli. Twenty PD patients (all men; mean age ± SD, 58.3 ± 6 years) in bilateral STN DBS switched ON and OFF conditions and 18 matched controls rated pictures selected from the International Affective Picture System according to emotional valence (unpleasantness/pleasantness) and arousal on 2 independent visual scales ranging from 1 to 9. Eighty-four pictures depicting primary rewarding (erotica and food) and aversive fearful (victims and threat) and neutral stimuli were selected for this study. In the STN DBS ON condition, the PD patients attributed lower valence scores to the aversive pictures compared with the OFF condition (P < .01) and compared with controls (P < .01). The difference between the OFF condition and controls was less pronounced (P < .05). Furthermore, postoperative weight gain correlated with arousal ratings from the food pictures in the STN DBS ON condition (P < .05 compensated for OFF condition). Our results suggest that STN DBS increases activation of the aversive motivational system so that more relevance is attributed to aversive fearful stimuli. In addition, STN DBS-related sensitivity to food reward stimuli cues might drive DBS-treated patients to higher food intake and subsequent weight gain.
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Affiliation(s)
- Tereza Serranová
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic.
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Vicente S, Péron J, Biseul I, Ory S, Philippot P, Drapier S, Drapier D, Vérin M. Subjective emotional experience at different stages of Parkinson's disease. J Neurol Sci 2011; 310:241-7. [PMID: 21741663 DOI: 10.1016/j.jns.2011.06.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 05/31/2011] [Accepted: 06/18/2011] [Indexed: 11/28/2022]
Abstract
Subjective emotional experience is thought to rely on a large cortical-subcortical network including orbitofrontal and cingulate frontostriatal circuits together with the mesolimbic dopaminergic system that modulates their activity. Parkinson's disease (PD) provides a model for exploring this issue. By using an original emotion induction procedure, the present study examined to what extent subjective experience of emotion of PD patients at different stages of the disease was modulated by emotion in the same way as healthy individuals. A battery of film excerpts was used to elicit different emotional feelings (happiness, anger, fear, sadness, disgust, and neutral) in 15 newly diagnosed PD patients, 18 patients with advanced PD and 15 matched controls. The newly diagnosed patients were examined in two conditions: "on" and "off" dopaminergic medication. Participants reported the intensity of their emotional feelings on a scale consisting of 10 emotional categories. Results indicated that PD patients at different stages of the disease did not significantly differ from the controls in the self-reported emotional experience to the presented film excerpts. Moreover, analyses conducted within the newly diagnosed PD group (on-dopa vs. off-dopa conditions) indicated that the patients' emotional reactivity to the presented film excerpts was not significantly modulated by dopaminergic medication. These results thus question the possible role of dopaminergic pathways in subjective emotional experience, at least in this sample and in the context of emotion induction.
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Affiliation(s)
- Siobhan Vicente
- Centre de Recherches sur la Cognition et l'Apprentissage, UMR CNRS 6234, Université de Poitiers, France.
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Stimulation at dorsal and ventral electrode contacts targeted at the subthalamic nucleus has different effects on motor and emotion functions in Parkinson's disease. Neuropsychologia 2011; 49:528-34. [DOI: 10.1016/j.neuropsychologia.2010.12.030] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 12/10/2010] [Accepted: 12/15/2010] [Indexed: 11/22/2022]
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Subthalamic nucleus stimulation affects limbic and associative circuits: a PET study. Eur J Nucl Med Mol Imaging 2010; 37:1512-20. [PMID: 20349231 DOI: 10.1007/s00259-010-1436-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 02/24/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE Although high-frequency deep brain stimulation of the subthalamic nucleus (STN DBS) improves motor symptoms in advanced Parkinson's disease (PD), clinical studies have reported cognitive, motivational and emotional changes. These results suggest that the STN forms part of a broadly distributed neural network encompassing the associative and limbic circuits. We sought to pinpoint the cortical and subcortical brain areas modulated by STN DBS, in order to assess the STN's functional role and explain neuropsychological modifications following STN DBS in PD. METHODS We studied resting state glucose metabolism in 20 PD patients before and after STN DBS and 13 age-matched healthy controls using (18)F-FDG PET. We used statistical analysis (SPM2) first to compare pre-stimulation metabolism in PD patients with metabolism in healthy controls, then to study metabolic modifications in PD patients following STN DBS. RESULTS The first analysis revealed no pre-stimulation metabolic abnormalities in associative or limbic circuitry. After STN DBS, metabolic modifications were found in several regions known for their involvement in the limbic and associative circuits. CONCLUSION These metabolic results confirm the STN's central role in associative and limbic basal ganglia circuits. They will provide information for working hypotheses for future studies investigating neuropsychological changes and metabolic modifications related to STN DBS, with a view to improving our knowledge of this structure's functional role.
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Péron J, Grandjean D, Le Jeune F, Sauleau P, Haegelen C, Drapier D, Rouaud T, Drapier S, Vérin M. Recognition of emotional prosody is altered after subthalamic nucleus deep brain stimulation in Parkinson's disease. Neuropsychologia 2010; 48:1053-62. [DOI: 10.1016/j.neuropsychologia.2009.12.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 11/20/2009] [Accepted: 12/03/2009] [Indexed: 10/20/2022]
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