Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul;234(7):1837-1848.
doi: 10.1007/s00221-016-4577-9. Epub 2016 Feb 18.

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

Inês Pote  1   2   3 , Mariam Torkamani  1   2 , Zinovia-Maria Kefalopoulou  1 , Ludvic Zrinzo  1 , Patricia Limousin-Dowsey  1 , Thomas Foltynie  1 , Maarten Speekenbrink  4 , Marjan Jahanshahi  5   6
Affiliations

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

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

Abstract

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

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

PubMed Disclaimer

Figures

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

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Afsharpour S. Topographical projections of the cerebral cortex to the subthalamic nucleus. J Comp Neurol. 1985;236(1):14–28. doi: 10.1002/cne.902360103. - DOI - PubMed
    1. Aron AR, Behrens TE, Smith S, Frank MJ, Poldrack RA. Triangulating a cognitive control network using diffusion-weighted magnetic resonance imaging (MRI) and functional MRI. J. Neurosci. 2007;27:3743–3752. doi: 10.1523/JNEUROSCI.0519-07.2007. - DOI - PMC - PubMed
    1. Ballanger B, van Eimeren T, Moro E, Lozano AM, Hamani C, Boulinguez P, et al. Stimulation of the subthalamic nucleus and impulsivity: release your horses. Ann Neurol. 2009;66(6):817–824. doi: 10.1002/ana.21795. - DOI - PMC - PubMed
    1. Beck AT, Steer RA, Brown GK, editors. Manual for the Beck Depression Inventory-II. San Antonio: Psychological Corporation; 1996.
    1. Bogacz R, Turner R. Cortico-striatal connections predict control over speed and accuracy in perceptual decision-making. PNAS. 2010;107(36):15916–15920. doi: 10.1073/pnas.1004932107. - DOI - PMC - PubMed

Publication types

LinkOut - more resources