Neuronal activity correlated with checking behaviour in the subthalamic nucleus of patients with obsessive-compulsive disorder.
Doubt, and its behavioural correlate, checking, is a normal phenomenon of human cognition that is dramatically exacerbated in obsessive-compulsive disorder. We recently showed that deep brain stimulation in the associative-limbic area of the subthalamic nucleus, a central core of the basal ganglia, improved obsessive-compulsive disorder. To understand the physiological bases of symptoms in such patients, we recorded the activity of individual neurons in the therapeutic target during surgery while subjects performed a cognitive task that gave them the possibility of unrestricted repetitive checking after they had made a choice. We postulated that the activity of neurons in this region could be influenced by doubt and checking behaviour. Among the 63/87 task-related neurons recorded in 10 patients, 60% responded to various combinations of instructions, delay, movement or feedback, thus highlighting their role in the integration of different types of information. In addition, task-related activity directed towards decision-making increased during trials with checking in comparison with those without checking. These results suggest that the associative-limbic subthalamic nucleus plays a role in doubt-related repetitive thoughts. Overall, our results not only provide new insight into the role of the subthalamic nucleus in human cognition but also support the fact that subthalamic nucleus modulation by deep brain stimulation reduced compulsive behaviour in patients with obsessive-compulsive disorder.
Institut des Maladies Neurodégénératives, CNRS UMR5293, Université Victor Segalen, 146, rue Léo Saignat, 33076 Bordeaux, France. Pierre.Burbaud@u-bordeaux2.fr
Pierre
P
Burbaud
Anne-Hélène
AH
Clair
Nicolas
N
Langbour
Sara
S
Fernandez-Vidal
Michel
M
Goillandeau
Thomas
T
Michelet
Eric
E
Bardinet
Isabelle
I
Chéreau
Franck
F
Durif
Mircea
M
Polosan
Stephan
S
Chabardès
Denys
D
Fontaine
Marie-Noelle
MN
Magnié-Mauro
Jean-Luc
JL
Houeto
Benoît
B
Bataille
Bruno
B
Millet
Marc
M
Vérin
Nicolas
N
Baup
Marie-Odile
MO
Krebs
Philippe
P
Cornu
Antoine
A
Pelissolo
Christophe
C
Arbus
Marion
M
Simonetta-Moreau
Jérôme
J
Yelnik
Marie-Laure
ML
Welter
Luc
L
Mallet
D000328:Adult; D003192:Compulsive Behavior / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000502:physiology*; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology* / Q000523:psychology; D020531:Subthalamic Nucleus / Q000503:physiopathology*