title: Subthalamic nucleus stimulation affects theory of mind network: a PET study in Parkinson's disease.
abstract: BACKGROUND
  There appears to be an overlap between the limbic system, which is modulated by subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson's disease (PD), and the brain network that mediates theory of mind (ToM). Accordingly, the aim of the present study was to investigate the effects of STN DBS on ToM of PD patients and to correlate ToM modifications with changes in glucose metabolism.
  
  
  RESULTS
  To this end, we conducted (18)FDG-PET scans in 13 PD patients in pre- and post-STN DBS conditions and correlated changes in their glucose metabolism with modified performances on the Eyes test, a visual ToM task requiring them to describe thoughts or feelings conveyed by photographs of the eye region. Postoperative PD performances on this emotion recognition task were significantly worse than either preoperative PD performances or those of healthy controls (HC), whereas there was no significant difference between preoperative PD and HC. Conversely, PD patients in the postoperative condition performed within the normal range on the gender attribution task included in the Eyes test. As far as the metabolic results are concerned, there were correlations between decreased cerebral glucose metabolism and impaired ToM in several cortical areas: the bilateral cingulate gyrus (BA 31), right middle frontal gyrus (BA 8, 9 and 10), left middle frontal gyrus (BA 6), temporal lobe (fusiform gyrus, BA 20), bilateral parietal lobe (right BA 3 and right and left BA 7) and bilateral occipital lobe (BA 19). There were also correlations between increased cerebral glucose metabolism and impaired ToM in the left superior temporal gyrus (BA 22), left inferior frontal gyrus (BA 13 and BA 47) and right inferior frontal gyrus (BA 47). All these structures overlap with the brain network that mediates ToM.
  
  
  CONCLUSIONS
  These results seem to confirm that STN DBS hinders the ability to infer the mental states of others and modulates a distributed network known to subtend ToM.
authors.affiliation: Clinique Neurologique, Hôpital Pontchaillou, Centre Hospitalier Universitaire de Rennes, Rennes, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Péron
authors.forename: Florence
authors.initials: F
authors.lastname: Le Jeune
authors.forename: Claire
authors.initials: C
authors.lastname: Haegelen
authors.forename: Thibaut
authors.initials: T
authors.lastname: Dondaine
authors.forename: Dominique
authors.initials: D
authors.lastname: Drapier
authors.forename: Paul
authors.initials: P
authors.lastname: Sauleau
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Reymann
authors.forename: Sophie
authors.initials: S
authors.lastname: Drapier
authors.forename: Tiphaine
authors.initials: T
authors.lastname: Rouaud
authors.forename: Bruno
authors.initials: B
authors.lastname: Millet
authors.forename: Marc
authors.initials: M
authors.lastname: Vérin
mesh_terms: D000368:Aged; D001931:Brain Mapping; D016022:Case-Control Studies; D046690:Deep Brain Stimulation; D004644:Emotions; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008032:Limbic System / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods*; D020531:Subthalamic Nucleus / Q000378:metabolism*
chemical_list: D019788:Fluorodeoxyglucose F18; D005947:Glucose