title: Deep Brain Stimulation of the Subthalamic Nucleus Improves Lexical Switching in Parkinsons Disease Patients.
abstract: OBJECTIVE
  Reduced verbal fluency (VF) has been reported in patients with Parkinson's disease (PD), especially those treated by Deep Brain Stimulation of the subthalamic nucleus (STN DBS). To delineate the nature of this dysfunction we aimed at identifying the particular VF-related operations modified by STN DBS.
  
  
  METHODS
  Eleven PD patients performed VF tasks in their STN DBS ON and OFF condition. To differentiate VF-components modulated by the stimulation, a temporal cluster analysis was performed, separating production spurts (i.e., 'clusters' as correlates of automatic activation spread within lexical fields) from slower cluster transitions (i.e., 'switches' reflecting set-shifting towards new lexical fields). The results were compared to those of eleven healthy control subjects.
  
  
  RESULTS
  PD patients produced significantly more switches accompanied by shorter switch times in the STN DBS ON compared to the STN DBS OFF condition. The number of clusters and time intervals between words within clusters were not affected by the treatment state. Although switch behavior in patients with DBS ON improved, their task performance was still lower compared to that of healthy controls.
  
  
  CONCLUSIONS
  Beyond impacting on motor symptoms, STN DBS seems to influence the dynamics of cognitive procedures. Specifically, the results are in line with basal ganglia roles for cognitive switching, in the particular case of VF, from prevailing lexical concepts to new ones.
authors: Dept. of Neurology, Motor and Cognition Group, Charité-University Medicine Berlin, Berlin, Germany.
authors: Isabelle
authors: I
authors: Vonberg
authors: Dept. of Neurology, Motor and Cognition Group, Charité-University Medicine Berlin, Berlin, Germany.
authors: Felicitas
authors: F
authors: Ehlen
authors: Dept. of Neurology, Motor and Cognition Group, Charité-University Medicine Berlin, Berlin, Germany.
authors: Ortwin
authors: O
authors: Fromm
authors: Dept. of Neurology, Motor Neuroscience Group, Berlin, Charité-University Medicine Berlin, Germany.
authors: Andrea A
authors: AA
authors: Kühn
authors: Dept. of Neurology, Motor and Cognition Group, Charité-University Medicine Berlin, Berlin, Germany.
authors: Fabian
authors: F
authors: Klostermann
mesh_terms: D000368:Aged; D016000:Cluster Analysis; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D013060:Speech / Q000502:physiology*; D020531:Subthalamic Nucleus / Q000503:physiopathology*; D013647:Task Performance and Analysis; D016896:Treatment Outcome