Mapping Go–No-Go performance within the subthalamic nucleus region

Abstract

The basal ganglia are thought to be important in the selection of wanted and the suppression of unwanted motor patterns according to explicit rules (i.e. response inhibition). The subthalamic nucleus has been hypothesized to play a particularly critical role in this function. Deep brain stimulation of the subthalamic nucleus in individuals with Parkinson's disease has been used to test this hypothesis, but results have been variable. Based on current knowledge of the anatomical organization of the subthalamic nucleus, we propose that the location of the contacts used in deep brain stimulation could explain variability in the effects of deep brain stimulation of the subthalamic nucleus on response inhibition tasks. We hypothesized that stimulation affecting the dorsal subthalamic nucleus (connected to the motor cortex) would be more likely to affect motor symptoms of Parkinson's disease, and stimulation affecting the ventral subthalamic nucleus (connected to higher order cortical regions) would be more likely to affect performance on a response inhibition task. We recruited 10 individuals with Parkinson's disease and bilateral deep brain stimulation of the subthalamic nucleus with one contact in the dorsal and another in the ventral subthalamic region on one side of the brain. Patients were tested with a Go-No-Go task and a motor rating scale in three conditions: stimulation off, unilateral dorsal stimulation and unilateral ventral stimulation. Both dorsal and ventral stimulation improved motor symptoms, but only ventral subthalamic stimulation affected Go-No-Go performance, decreasing hits and increasing false alarms, but not altering reaction times. These results suggest that the ventral subthalamic nucleus is involved in the balance between appropriate selection and inhibition of prepotent responses in cognitive paradigms, but that a wide area of the subthalamic nucleus region is involved in the motor symptoms of Parkinson's disease. This finding has implications for resolving inconsistencies in previous research, highlights the role of the ventral subthalamic nucleus region in response inhibition and suggests an approach for the clinical optimization of deep brain stimulation of the subthalamic nucleus for both motor and cognitive functions.

Weight gain after STN-DBS: The role of reward sensitivity and impulsivity

“…Importantly, patients' performance improved when they were tested in the on medication/on stimulation condition several months after surgery. Coherently with our findings, STN-DBS has been found to be associated with deficits in go/no-go tasks (Hershey et al, 2004(Hershey et al, , 2010Georgiev et al, 2016but see van den Wildenberg et al, 2006. To our knowledge, this is the first study in which patients' performance has been assessed before and after surgery in two conditions, and in which lesion and stimulation effects have been disentangled.…”

“…Moreover, STN-DBS or subthalamotomy in Parkinson's disease can be associated with behavioural and psychiatric problems that reflect deficits in inhibitory control or with the appearance of impulse control disorders (see Jahanshahi et al, 2014;Balarajah & Cavanna, 2013). For instance, several studies in which go/no-go paradigms were used reported that STN-DBS impairs the ability to withhold responses on no-go trials (Hershey et al, 2004(Hershey et al, , 2010Ballanger et al, 2009;Georgiev et al, 2016; but see also van den Wildenberg et al, 2006). To our knowledge, no research until now has examined the role of impulsivity in weight gain after STN-DBS.…”

Impulsivity and Parkinson's disease: More than just disinhibition

“…[87][88][89][90][91]. Such discrepancies in the literature may be explained by more general improvements on the task due to improved motor control [92], dissociable temporal effects of stimulation that result in increased impulsive responding as well as improvements in the engagement of inhibitory processes [93], or differences in the effect of STN DBS on inhibitory control depending on whether the ventral or dorsal STN is stimulated [94].…”

Right frontal stroke: extra-frontal lesions, executive functioning and impulsive behaviour

“…Anterior cingulate activity was related to the number of errors, whereas the parietal region was related to preparation and execution of the motor response and to errors of commission on no-go trials. Further evidence for the involvement of extra-frontal regions in inhibitory control was provided by a study of patients with Parkinson's disease which showed that the sub-thalamic nucleus was involved in the inhibition of responses on the Go/No-Go Task (Hershey et al 2010).…”