title: The Subthalamic Nucleus, Limbic Function, and Impulse Control.
abstract: It has been well documented that deep brain stimulation (DBS) of the subthalamic nucleus (STN) to address some of the disabling motor symptoms of Parkinson's disease (PD) can evoke unintended effects, especially on non-motor behavior. This observation has catalyzed more than a decade of research concentrated on establishing trends and identifying potential mechanisms for these non-motor effects. While many issues remain unresolved, the collective result of many research studies and clinical observations has been a general recognition of the role of the STN in mediating limbic function. In particular, the STN has been implicated in impulse control and the related construct of valence processing. A better understanding of STN involvement in these phenomena could have important implications for treating impulse control disorders (ICDs). ICDs affect up to 40% of PD patients on dopamine agonist therapy and approximately 15% of PD patients overall. ICDs have been reported to be associated with STN DBS. In this paper we will focus on impulse control and review pre-clinical, clinical, behavioral, imaging, and electrophysiological studies pertaining to the limbic function of the STN.
authors.affiliation: Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA. pjrossi@ufl.edu.|Department of Neurology, University of Florida College of Medicine, HSC Box 100236, Gainesville, FL, 32610-0236, USA. pjrossi@ufl.edu.
authors.forename: P Justin
authors.initials: PJ
authors.lastname: Rossi
authors.affiliation: J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
authors.forename: Aysegul
authors.initials: A
authors.lastname: Gunduz
authors.affiliation: Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
mesh_terms: D000818:Animals; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000379:methods; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D007175:Impulsive Behavior / Q000502:physiology*; D008032:Limbic System / Q000503:physiopathology*; D009434:Neural Pathways / Q000503:physiopathology; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D020531:Subthalamic Nucleus / Q000503:physiopathology*
keywords: Deep brain stimulation; Impulse control disorder; Subthalamic nucleus