Neuronal activity correlated with checking behaviour in the subthalamic nucleus of patients with obsessive–compulsive disorder

Abstract

Doubt, and its behavioural correlate, checking, is a normal phenomenon of human cognition that is dramatically exacerbated in obsessive-compulsive disorder. We recently showed that deep brain stimulation in the associative-limbic area of the subthalamic nucleus, a central core of the basal ganglia, improved obsessive-compulsive disorder. To understand the physiological bases of symptoms in such patients, we recorded the activity of individual neurons in the therapeutic target during surgery while subjects performed a cognitive task that gave them the possibility of unrestricted repetitive checking after they had made a choice. We postulated that the activity of neurons in this region could be influenced by doubt and checking behaviour. Among the 63/87 task-related neurons recorded in 10 patients, 60% responded to various combinations of instructions, delay, movement or feedback, thus highlighting their role in the integration of different types of information. In addition, task-related activity directed towards decision-making increased during trials with checking in comparison with those without checking. These results suggest that the associative-limbic subthalamic nucleus plays a role in doubt-related repetitive thoughts. Overall, our results not only provide new insight into the role of the subthalamic nucleus in human cognition but also support the fact that subthalamic nucleus modulation by deep brain stimulation reduced compulsive behaviour in patients with obsessive-compulsive disorder.

Response inhibition rapidly increases single-neuron responses in the subthalamic nucleus of patients with Parkinson's disease

“…Conversely, we also note that the presence of two identical functional neuronal subpopulations (GO and STOP cells) in the STN of both OCD and PD patients is also compatible with models postulating that the STN may actually integrate motor, associative and limbic information via modulations of firing rate in different neuronal populations (Burbaud et al, 2013;Peron, Frü hholz, Verin, & Grandjean, 2013;Temel, Blokland, Steinbusch, & Visser-Vandewalle, 2005). Note, however, that the low number of task-responsive cells found in both studies combined with the absence of high resolution clinical anatomical images and tractography data did not allow us to provide clearer empirical support for hypotheses related to STN functional territories.…”

The Subthalamic Nucleus, Limbic Function, and Impulse Control

“…Checking was defined as a reviewing the images before submitting their answer for feedback, a behavior that is known to be exacerbated in OCD. Interestingly, this study also found that 60% of neurons responded to combinations of movement and feedback, suggesting that the STN plays a role in integrating different types of information (Burbaud et al ., 2013). …”

Changes of oscillatory activity in the subthalamic nucleus during obsessive-compulsive disorder symptoms: Two case reports

“…In OCD, increased oscillatory activity has also been observed in the STN and was found to correlate with the severity of OCD (Welter et al, 2011). Furthermore, some subthalamic neurons specifically increased their firing rate when doubt occurred during a verification task (Burbaud et al, 2013). Thus, we speculate that the increase in STN oscillations during acute OCD symptoms might correspond to a compensatory mechanism that aims at overcoming obsessions.…”