Cognitive and emotional effects of Deep Brain Stimulation of the Subthalamic Nucleus in patients with Parkinson's disease [article]

Caroline Wagenbreth, Tino Zähle, Martin-Luther Universität, Universitäts- Und Landesbibliothek Sachsen-Anhalt
2019
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become an effective and secure option for treatment of Parkinson´s disease (PD). Its effect on improving motor impairments following dopaminergic depletion in the substantia nigra has been variously shown. The influence of STN-DBS on concomitant non-motor symptoms has also reached more and more of attention, since these may have the potential to affect subjectively perceived quality of life in patients. Behavioral, affective and
more » ... ral, affective and cognitive changes in patients after STN-DBS have thus been considerably studied in recent years. The present thesis aimed to investigate STN-DBS modulations on different cognitive and emotional functions in PD patients. The STN is supposed to hold a crucial role in action selection and reward processing as well as in perceptual decision-making. The first thesis project investigated whether stimulation of the STN influences the patients´ selective ability to act for anticipated reward or loss, or whether DBS changes action selection independent from motivational valence. Behavioral results demonstrate the impact of STN-DBS on motivational action control in PD by selectively improving action execution when rewards are anticipated. Thus, STN-DBS establishes a reliable congruency between action and reward anticipation. The second project investigated whether STN-DBS in PD patients influences decision-making under difficult, high-risk decisions. Results show that stimulation of the STN affected perceptual decision-making depending on the difficulty of decisions and as a function of baseline impulsivity in patients. DBS of the STN selectively affected the tendency to stick with a default option on difficult decisions and increased accuracy of responses. Finally, I conducted an experimental setting to assess STN-DBS impact on implicit and explicit processing of emotional semantic and facial stimuli in an affective priming paradigm. I found that even reduced facial information is sufficient to induce automatic implicit emotional pr [...]
doi:10.25673/25382 fatcat:rjq5u3ixzrfhdmbmrwplahtwia