title: The impact of Parkinson's disease and subthalamic deep brain stimulation on reward processing.
abstract: BACKGROUND
  Due to its position in cortico-subthalamic and cortico-striatal pathways, the subthalamic nucleus (STN) is considered to play a crucial role not only in motor, but also in cognitive and motivational functions. In the present study we aimed to characterize how different aspects of reward processing are affected by disease and deep brain stimulation of the STN (DBS-STN) in patients with idiopathic Parkinson's disease (PD).
  
  
  METHODS
  We compared 33 PD patients treated with DBS-STN under best medical treatment (DBS-on, medication-on) to 33 PD patients without DBS, but optimized pharmacological treatment and 34 age-matched healthy controls. We then investigated DBS-STN effects using a postoperative stimulation-on/ -off design. The task set included a delay discounting task, a task to assess changes in incentive salience attribution, and the Iowa Gambling Task.
  
  
  RESULTS
  The presence of PD was associated with increased incentive salience attribution and devaluation of delayed rewards. Acute DBS-STN increased risky choices in the Iowa Gambling Task under DBS-on condition, but did not further affect incentive salience attribution or the evaluation of delayed rewards.
  
  
  CONCLUSIONS
  Findings indicate that acute DBS-STN affects specific aspects of reward processing, including the weighting of gains and losses, while larger-scale effects of disease or medication are predominant in others reward-related functions.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany. Electronic address: ricarda.evens@tu-dresden.de.
authors.forename: Ricarda
authors.initials: R
authors.lastname: Evens
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: Yuliya
authors.initials: Y
authors.lastname: Stankevich
authors.affiliation: Department of Psychology, Technische Universität Dresden, Dresden, Germany.
authors.forename: Maja
authors.initials: M
authors.lastname: Dshemuchadse
authors.affiliation: Department of Neurology, Technische Universität Dresden, Dresden, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Storch
authors.affiliation: Department of Neurology, Elblandklinikum, Meissen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Wolz
authors.affiliation: Department of Neurology, Technische Universität Dresden, Dresden, Germany.
authors.forename: Heinz
authors.initials: H
authors.lastname: Reichmann
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany; Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, USA.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Schlaepfer
authors.affiliation: Department of Psychology, Technische Universität Dresden, Dresden, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Goschke
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Lueken
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation; D065786:Delay Discounting / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000502:physiology*; D010300:Parkinson Disease / Q000503:physiopathology* / Q000628:therapy; D012201:Reward; D012309:Risk-Taking; D020531:Subthalamic Nucleus / Q000503:physiopathology*
keywords: Deep brain stimulation; Delay discounting; Iowa Gambling Task; Parkinson’s disease; Subthalamic nucleus