Effects of deep brain stimulation of the subthalamic nucleus on perceptual decision making. (20th February 2017)

• Record Type: Journal Article
• Authors: Zaehle, Tino; Wagenbreth, Caroline; Voges, Jürgen; Heinze, Hans-Jochen; Galazky, Imke
• Is Part Of: Neuroscience. Volume 343(2017)
• Page Start: 140
• Page End: 146
• Publication Date: 2017-02-20
• Subjects: DBS deep brain stimulation -- OCD obsessive-compulsive diseases -- PD Parkinson's disease -- STN Subthalamic Nucleus; STN -- DBS -- PD -- decision making; Neurochemistry -- Periodicals; Neurophysiology -- Periodicals; Neurology -- Periodicals; Neurochimie -- Périodiques; Neurophysiologie -- Périodiques; Neurochemistry; Neurophysiology; Electronic journals; Periodicals; Electronic journals; 612.8
• DOI: 10.1016/j.neuroscience.2016.11.044
• Languages: English
• ISSNs: 0306-4522

Abstract

Highlights: STN-DBS in PD modulates perceptual decision-making. STN-DBS effects are inter-individually variable and depend on baseline cognitive abilities of the PD patients. Pre-OP evaluation of individual impulsivity might be able to reduce the risk of STN-DBS induced impulse control disorders. Abstract: When faced with difficult decisions, people prefer to stay with the default. This status quo bias often leads to suboptimal choice behavior. Neurophysiological evidence suggests a pivot role of the Subthalamic Nucleus (STN) for overcoming such status quo bias in difficult decisions, but causal evidence is lacking. The present study investigated whether subthalamic deep brain stimulation (DBS) in patients with Parkinson's disease (PD) influences the status quo bias. Eighteen PD patients treated with STN-DBS performed a difficult perceptual decision task incorporating intrinsic status quo option. Patients were tested with (ON) and without (OFF) active STN stimulation. Our results show that DBS of the STN affected perceptual decision making in PD patients depending on the difficulty of decision. STN-DBS improved difficult perceptual decisions due to a selective increase in accuracy (hit rate) that was independent of response bias (no effect on false alarm rate). Furthermore, STN-DBS impacted status quo bias as a function of baseline impulsivity. In impulsive patients, STN-DBS increased the default bias, whereas in less impulsive PD patients, DBS of the STN reduced the status quo bias. In line with our hypothesis, STN-DBS selectively affected the tendency to stick with the default option on difficult decisions, and promoted increased decision accuracy. Moreover, we demonstrate the impact of baseline cognitive abilities on DBS-related performance changes in PD patients.