title: No Effect of Subthalamic Deep Brain Stimulation on Intertemporal Decision-Making in Parkinson Patients.
abstract: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a widely used treatment for the motor symptoms of Parkinson's disease (PD). DBS or pharmacological treatment is believed to modulate the tendency to, or reverse, impulse control disorders. Several brain areas involved in impulsivity and reward valuation, such as the prefrontal cortex and striatum, are linked to the STN, and activity in these areas might be affected by STN-DBS. To investigate the effect of STN-DBS on one type of impulsive decision-making--delay discounting (i.e., the devaluation of reward with increasing delay until its receipt)--we tested 40 human PD patients receiving STN-DBS treatment and medication for at least 3 months. Patients were pseudo-randomly assigned to one of four groups to test the effects of DBS on/off states as well as medication on/off states on delay discounting. The delay-discounting task consisted of a series of choices among a smaller. sooner or a larger, later monetary reward. Despite considerable effects of DBS on motor performance, patients receiving STN-DBS did not choose more or less impulsively compared with those in the off-DBS group, as well as when controlling for risk attitude. Although null results have to be interpreted with caution, our findings are of significance to other researchers studying the effects of PD treatment on impulsive decision-making, and they are of clinical relevance for determining the therapeutic benefits of using STN-DBS.
authors.affiliation: Comparative Psychology, Institute of Experimental Psychology, Heinrich-Heine University Düsseldorf , 40225 Düsseldorf, Germany.
authors.forename: Maayke
authors.initials: M
authors.lastname: Seinstra
authors.affiliation: Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf , 40225 Düsseldorf, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Wojtecki
authors.affiliation: Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf , 40225 Düsseldorf, Germany.
authors.forename: Lena
authors.initials: L
authors.lastname: Storzer
authors.affiliation: Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf , 40225 Düsseldorf, Germany.
authors.forename: Alfons
authors.initials: A
authors.lastname: Schnitzler
authors.affiliation: Comparative Psychology, Institute of Experimental Psychology, Heinrich-Heine University Düsseldorf , 40225 Düsseldorf, Germany.
authors.forename: Tobias
authors.identifier: 0000-0002-0358-9020
authors.initials: T
authors.lastname: Kalenscher
mesh_terms: D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000209:etiology; D003657:Decision Making; D046690:Deep Brain Stimulation; D065786:Delay Discounting / Q000502:physiology; D005260:Female; D005717:Games, Experimental; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D020531:Subthalamic Nucleus / Q000502:physiology*; D011795:Surveys and Questionnaires
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Parkinson’s disease; deep brain stimulation; intertemporal choice