Deep brain stimulation of the subthalamic nucleus enhances emotional processing in Parkinson disease.
BACKGROUND
High-frequency electrical stimulation of the subthalamic nucleus is a new and highly effective therapy for complications of long-term levodopa therapy and motor symptoms in advanced Parkinson disease (PD). Clinical observations indicate additional influence on emotional behavior.


METHODS
Electrical stimulation of deep brain nuclei with pulse rates above 100 Hz provokes a reversible, lesioning-like effect. Here, the effect of deep brain stimulation of the subthalamic nucleus on emotional, cognitive, and motor performance in patients with PD (n = 12) was examined. The results were compared with the effects of a suprathreshold dose of levodopa intended to transiently restore striatal dopamine deficiency. Patients were tested during medication off/stimulation off (STIM OFF), medication off/stimulation on (STIM ON), and during the best motor state after taking levodopa without deep brain stimulation (MED).


RESULTS
More positive self-reported mood and an enhanced mood induction effect as well as improvement in emotional memory during STIM ON were observed, while during STIM OFF, patients revealed reduced emotional performance. Comparable effects were revealed by STIM ON and MED. Cognitive performance was not affected by the different conditions and treatments.


CONCLUSIONS
Deep brain stimulation of the subthalamic nucleus selectively enhanced affective processing and subjective well-being and seemed to be antidepressive. Levodopa and deep brain stimulation had similar effects on emotion. This finding may provide new clues about the neurobiologic bases of emotion and mood disorders, and it illustrates the important role of the basal ganglia and the dopaminergic system in emotional processing in addition to the well-known motor and cognitive functions.
Schneider
Frank
F
Department of Psychiatry and Psychotherapy, University of Düsseldorf, Germany. frank.schneider@uni-duesseldorf.de
Habel
Ute
U
Volkmann
Jens
J
Regel
Sabine
S
Kornischka
Jürgen
J
Sturm
Volker
V
Freund
Hans-Joachim
HJ
D001479:Basal Ganglia / Q000502:physiology; D001921:Brain / Q000502:physiology*; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D004298:Dopamine / Q000502:physiology; D004599:Electric Stimulation Therapy / Q000379:methods*; D004644:Emotions / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008568:Memory / Q000187:drug effects / Q000502:physiology; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D010300:Parkinson Disease / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D020531:Subthalamic Nucleus / Q000502:physiology*; D009435:Synaptic Transmission / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome; D014705:Verbal Behavior / Q000187:drug effects / Q000502:physiology
D007980:Levodopa; D004298:Dopamine