title: Facilitating effects of deep brain stimulation on feedback learning in Parkinson's disease.
abstract: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) provides an effective treatment for Parkinson's disease (PD) motor symptoms. However, findings of effects on cognitive function such as feedback learning remain controversial and rare. The aim of the present study was to gain a better understanding of cognitive alterations associated with STN-DBS. Therefore, we investigated effects of STN-DBS on active and observational feedback learning in PD. 18 PD patients with STN-DBS and 18 matched healthy controls completed active and observational feedback learning tasks. Patients were investigated ON and OFF STN-DBS. Tasks consisted of learning (with feedback) and test phases (without feedback). STN-DBS improved active learning during feedback trials and PD patients ON (but not OFF) STN-DBS showed comparable performance patterns as healthy controls. No STN-DBS effect was found when assessing performance during active test trials without feedback. In this case, however, STN-DBS effects were found to depend on symptom severity. While more impaired patients benefited from STN-DBS, stimulation had no facilitating effect on patients with less severe symptoms. Along similar lines, the severity of motor symptoms tended to be significantly correlated with differences in active test performance due to STN-DBS. For observational feedback learning, there was a tendency for a positive STN-DBS effect with patients reaching the performance level of healthy controls only ON STN-DBS. The present data suggest that STN-DBS facilitates active feedback learning in PD patients. Furthermore, they provide first evidence that STN-DBS might not only affect learning from own but also from observed actions and outcomes.
authors.affiliation: Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University, Medical Faculty, Universitaetsstraße 1, 40225 Duesseldorf, Germany. Electronic address: sarah.meissner@med.uni-duesseldorf.de.
authors.forename: Sarah Nadine
authors.initials: SN
authors.lastname: Meissner
authors.affiliation: Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University, Medical Faculty, Universitaetsstraße 1, 40225 Duesseldorf, Germany; Department of Neurology, Heinrich-Heine-University, Medical Faculty, Moorenstraße 5, 40225 Duesseldorf, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Südmeyer
authors.affiliation: Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University, Medical Faculty, Universitaetsstraße 1, 40225 Duesseldorf, Germany.
authors.forename: Ariane
authors.initials: A
authors.lastname: Keitel
authors.affiliation: Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University, Medical Faculty, Universitaetsstraße 1, 40225 Duesseldorf, Germany.
authors.forename: Bettina
authors.initials: B
authors.lastname: Pollok
authors.affiliation: Institute for Experimental Psychology, Heinrich-Heine-University, Universitaetsstraße 1, 40225 Duesseldorf, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Bellebaum
mesh_terms: D046690:Deep Brain Stimulation; D005260:Female; D000068156:Formative Feedback; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000523:psychology* / Q000628:therapy*; D020531:Subthalamic Nucleus / Q000503:physiopathology
keywords: Active feedback learning; Cognition; Deep brain stimulation; Observation; Parkinson’s disease