title: Sex, food and threat: startling changes after subthalamic stimulation in Parkinson's disease.
abstract: BACKGROUND
  Changes in motivational processing may play a role in weight gain and other non-motor side effects in Parkinson's disease (PD) patients treated with deep brain stimulation of the subthalamic nucleus.
  
  
  OBJECTIVE
  We aimed to assess changes in aversive and appetitive motivational activation using modulation of the acoustic blink reflex (ABR) by rewarding and aversive stimuli.
  
  
  METHODS
  ABR elicited during the viewing of erotic, food, aversive and neutral pictures was recorded in 11 off-medicated patients with the subthalamic stimulation switched ON and OFF, and in 11 control subjects.
  
  
  RESULTS
  ABR to erotic stimuli was larger in patients in the ON compared to the OFF condition and controls (P < 0.01). Aversive stimuli caused a larger increase in the ABR in patients with the ON condition than in controls (P < 0.05). Additionally, we found a negative correlation of the ABR magnitude to food pictures in the ON condition with weight gain following subthalamic stimulation (P < 0.01, after adjustment to OFF condition).
  
  
  CONCLUSIONS
  Our results suggest that subthalamic stimulation affects motivational processing. Subthalamic stimulation may disturb appetitive engagement by erotic cues and increase aversive activation in PD patients. Additionally, postoperative weight gain may be related to changes in the processing of food cues due to subthalamic stimulation.
authors.affiliation: Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic. Electronic address: tereza.serranova@gmail.com.
authors.forename: Tereza
authors.initials: T
authors.lastname: Serranová
authors.forename: Tomáš
authors.initials: T
authors.lastname: Sieger
authors.forename: Petr
authors.initials: P
authors.lastname: Dušek
authors.forename: Filip
authors.initials: F
authors.lastname: Růžička
authors.forename: Dušan
authors.initials: D
authors.lastname: Urgošík
authors.forename: Evžen
authors.initials: E
authors.lastname: Růžička
authors.forename: Josep
authors.initials: J
authors.lastname: Valls-Solé
authors.forename: Robert
authors.initials: R
authors.lastname: Jech
mesh_terms: D001767:Blinking; D046690:Deep Brain Stimulation; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000502:physiology*; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D012725:Sexual Behavior / Q000502:physiology*; D020531:Subthalamic Nucleus / Q000502:physiology
keywords: Acoustic blink reflex; Deep brain stimulation; Motivation; Weight gain