Subthalamic Nucleus Subregion Stimulation Modulates Inhibitory Control

Abstract

Patients with Parkinson’s disease (PD) often experience reductions in the proficiency to inhibit actions. The motor symptoms of PD can be effectively treated with deep brain stimulation (DBS) of the Subthalamic nucleus (STN), a key structure in the frontal-striatal network that may be directly involved in regulating inhibitory control. However, the precise role of the STN in stopping control is unclear. The STN consists of functional sub-territories linked to dissociable cortical networks although the boundaries of the subregions are still under debate. We investigated whether stimulating dorsal and ventral subregions of the STN would show dissociable effects on the ability to stop. We studied 12 PD patients with STN DBS. Patients with two adjacent contacts positioned within the bounds of the dorsal and ventral STN completed two testing sessions (off medication) with low amplitude stimulation (0.4mA) at either the dorsal or ventral contacts bilaterally while performing the stop task. Ventral, but not dorsal, DBS improved stopping latencies. Go reactions were similar between dorsal and ventral DBS STN. Stimulation in the ventral, but not dorsal, subregion of the STN improved stopping speed, confirming the involvement of the STN in stopping control and supporting STN functional subregions.

Altered Spontaneous Neural Activity and Functional Connectivity in Parkinson’s Disease With Subthalamic Microlesion

“…Secondly, although the unified standardized DBS surgery was adopted among PD patients via a neurosurgeon, we were still not able to control the absolute consistency of the position of electrodes implanted in all patients. In addition, the target implanted in this study was STN, which is divided into different sub-regions ( van Wijk et al, 2020 ; van Wouwe et al, 2020 ). The damage caused by implantation in different sub-regions can induce different alterations in brain function.…”

Clinical neuroscience and neurotechnology: An amazing symbiosis

“…The hypothesis that ventral STN might be dedicated to cognitive functions and dorsal STN to motor functions ( Jahanshahi et al., 2015 ) stems from the observation that prefrontal cortical areas project to the former, whereas motor and premotor cortices project to the latter ( Haynes and Haber, 2013 ). This observation has been corroborated by the effects on DBS outcome of the location of the target stimulation in the dorsoventral/occipitorostral axis of the STN ( Greenhouse et al., 2013 ; Scherrer et al., 2020 ; van Wouwe et al., 2017 , 2020 ).…”

Increased Subthalamic Nucleus Deep Brain Stimulation Amplitude Impairs Inhibitory Control of Eye Movements in Parkinson's Disease

“…Upper limb inhibitory control has been tested using various tasks such as the stop-signal, Simon, and Go/No-Go tasks. During the stop-signal task, STN DBS has been shown to improve [34][35][36][37] or worsen 38,39 measures of reactive inhibition and to improve measures of proactive inhibition. 39,40 However, it should be acknowledged that one study reporting worsened stop-signal performance used the more cognitively demanding conditional stop-signal task suggesting that the impairment with STN DBS could have been due to other executive functions rather than inhibitory control.…”