title: Focused stimulation of dorsal subthalamic nucleus improves reactive inhibitory control of action impulses.
abstract: Frontal-basal ganglia circuitry dysfunction caused by Parkinson's disease impairs important executive cognitive processes, such as the ability to inhibit impulsive action tendencies. Subthalamic Nucleus Deep Brain Stimulation in Parkinson's disease improves the reactive inhibition of impulsive actions that interfere with goal-directed behavior. An unresolved question is whether this effect depends on stimulation of a particular Subthalamic Nucleus subregion. The current study aimed to 1) replicate previous findings and additionally investigate the effect of chronic versus acute Subthalamic Nucleus stimulation on inhibitory control in Parkinson's disease patients off dopaminergic medication 2) test whether stimulating Subthalamic Nucleus subregions differentially modulate proactive response control and the proficiency of reactive inhibitory control. In the first experiment, twelve Parkinson's disease patients completed three sessions of the Simon task, Off Deep brain stimulation and medication, on acute Deep Brain Stimulation and on chronic Deep Brain Stimulation. Experiment 2 consisted of 11 Parkinson's disease patients with Subthalamic Nucleus Deep Brain Stimulation (off medication) who completed two testing sessions involving of a Simon task either with stimulation of the dorsal or the ventral contact in the Subthalamic Nucleus. Our findings show that Deep Brain Stimulation improves reactive inhibitory control, regardless of medication and regardless of whether it concerns chronic or acute Subthalamic Nucleus stimulation. More importantly, selective stimulation of dorsal and ventral subregions of the Subthalamic Nucleus indicates that especially the dorsal Subthalamic Nucleus circuitries are crucial for modulating the reactive inhibitory control of motor actions.
authors.affiliation: Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: nelleke.van.wouwe@vanderbilt.edu.
authors.forename: N C
authors.initials: NC
authors.lastname: van Wouwe
authors.affiliation: Department of Engineering, Vanderbilt University, Nashville, TN, USA.
authors.forename: S
authors.initials: S
authors.lastname: Pallavaram
authors.affiliation: Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: F T
authors.initials: FT
authors.lastname: Phibbs
authors.affiliation: Department of Neurology, University of Florida Medical Center, Gainesville, Florida, USA.
authors.forename: D
authors.initials: D
authors.lastname: Martinez-Ramirez
authors.affiliation: Department of Neurosurgery, University of Louisville Medical Center, Louisville, KY, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Neimat
authors.affiliation: Department of Engineering, Vanderbilt University, Nashville, TN, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Dawant
authors.affiliation: Department of Engineering, Vanderbilt University, Nashville, TN, USA.
authors.forename: P F
authors.initials: PF
authors.lastname: D'Haese
authors.affiliation: Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: K E
authors.initials: KE
authors.lastname: Kanoff
authors.affiliation: Cognitive Science Center Amsterdam and Psychology Department, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: W P M
authors.initials: WPM
authors.lastname: van den Wildenberg
authors.affiliation: Department of Neurology, University of Florida Medical Center, Gainesville, Florida, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Okun
authors.affiliation: Department of Neurosurgery, University of Louisville Medical Center, Louisville, KY, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Wylie
mesh_terms: D000978:Antiparkinson Agents / Q000627:therapeutic use; D046690:Deep Brain Stimulation / Q000379:methods; D015259:Dopamine Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007266:Inhibition, Psychological; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects / Q000502:physiology*; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D011930:Reaction Time / Q000187:drug effects / Q000502:physiology; D020531:Subthalamic Nucleus / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*
chemical_list: D000978:Antiparkinson Agents; D015259:Dopamine Agents
keywords: Inhibititory control; Parkinson's disease; Simon task; Subthalamic nucleus deep brain stimulation; Subthalamic nucleus subregions