Stimulation of STN impairs aspects of cognitive control in PD

Hershey, Tamara; Revilla, Fredy J.; Wernle, A.; Gibson, P. Schneider; Dowling, Joshua L.; Perlmutter, Joel S.

doi:10.1212/01.wnl.0000118202.19098.10

Cited by 176 publications

(118 citation statements)

References 44 publications

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“…Simulated STN lesions led to premature responding and impaired high-conflict decisions. This is consistent with observations that lesions of the STN in rodents produce premature responding (Baunez et al, 2001;Desbonnet et al, 2004) and that deep-brain stimulation of the STN can impair cognitive control (Hershey et al, 2004). A recent study shows that stimulating the STN interferes with patients' ability to modulate their RTs by the degree of response conflict, thereby causing impulsive behavior (M. J. Frank, J. Samanta, and S. J. Sherman, unpublished observation).…”

Section: Discussionsupporting

confidence: 88%

Triangulating a Cognitive Control Network Using Diffusion-Weighted Magnetic Resonance Imaging (MRI) and Functional MRI

Aron¹,

Behrens²,

Smith³

et al. 2007

J. Neurosci.

892

885

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The ability to stop motor responses depends critically on the right inferior frontal cortex (IFC) and also engages a midbrain region consistent with the subthalamic nucleus (STN). Here we used diffusion-weighted imaging (DWI) tractography to show that the IFC and the STN region are connected via a white matter tract, which could underlie a "hyperdirect" pathway for basal ganglia control. Using a novel method of "triangulation" analysis of tractography data, we also found that both the IFC and the STN region are connected with the presupplementary motor area (preSMA). We hypothesized that the preSMA could play a conflict detection/resolution role within a network between the preSMA, the IFC, and the STN region. A second experiment tested this idea with functional magnetic resonance imaging (fMRI) using a conditional stop-signal paradigm, enabling examination of behavioral and neural signatures of conflict-induced slowing. The preSMA, IFC, and STN region were significantly activated the greater the conflict-induced slowing. Activation corresponded strongly with spatial foci predicted by the DWI tract analysis, as well as with foci activated by complete response inhibition. The results illustrate how tractography can reveal connections that are verifiable with fMRI. The results also demonstrate a three-way functionalanatomical network in the right hemisphere that could either brake or completely stop responses.

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Section: Discussionsupporting

confidence: 88%

Triangulating a Cognitive Control Network Using Diffusion-Weighted Magnetic Resonance Imaging (MRI) and Functional MRI

Aron¹,

Behrens²,

Smith³

et al. 2007

J. Neurosci.

892

885

View full text Add to dashboard Cite

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“…DBS of the STN does appear to affect inhibitory motor control, but the literature disagrees on whether STN DBS is detrimental or beneficial. When DBS is turned "on" response inhibition is worse compared with DBS "off", as assessed by the Stroop test (Witt et al 2004) and go/no-go tasks (Ballanger et al 2009;Hershey et al 2004). In the stop-signal task (SST), where the movement response must be halted during preparation or execution phases, some studies have shown that STN DBS enhances inhibitory control by shortening the SST reaction time of arm (Mirabella et al 2012) and finger (Swann et al 2011;van den Wildenberg et al 2006) movements.…”

Section: Discussionmentioning

confidence: 99%

Compensatory stepping in Parkinson's disease is still a problem after deep brain stimulation randomized to STN or GPi

George

Carlson‐Kuhta

King

et al. 2015

Journal of Neurophysiology

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The effects of deep brain stimulation (DBS) on balance in people with Parkinson's disease (PD) are not well established. This study examined whether DBS randomized to the subthalamic nucleus (STN; n ϭ 11) or globus pallidus interna (GPi; n ϭ 10) improved compensatory stepping to recover balance after a perturbation. The standing surface translated backward, forcing subjects to take compensatory steps forward. Kinematic and kinetic responses were recorded. PD-DBS subjects were tested off and on their levodopa medication before bilateral DBS surgery and retested 6 mo later off and on DBS, combined with off and on levodopa medication. Responses were compared with PD-control subjects (n ϭ 8) tested over the same timescale and 17 healthy control subjects. Neither DBS nor levodopa improved the stepping response. Compensatory stepping in the best-treated state after surgery (DBSϩDOPA) was similar to the best-treated state before surgery (DOPA) for the PD-GPi group and the PD-control group. For the PD-STN group, there were more lateral weight shifts, a delayed foot-off, and a greater number of steps required to recover balance in DBSϩDOPA after surgery compared with DOPA before surgery. Within the STN group five subjects who did not fall during the experiment before surgery fell at least once after surgery, whereas the number of falls in the GPi and PD-control groups were unchanged. DBS did not improve the compensatory step response needed to recover from balance perturbations in the GPi group and caused delays in the preparation phase of the step in the STN group.

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“…In addition to the models of cognitive control in WM discussed above (e.g., Braver and Cohen, 2000;Casey et al, 2002;Miller and Cohen, 2001), clinical studies have demonstrated inhibitory deficits in a range of conditions involving the loss of corticostriatal pathways through degeneration of the striatum (e.g., Aron et al, 2003b;Casey et al, 1997;Cools et al, 2003;Lawrence et al, 1998;Rosenberg et al, 1996;Rubia et al, 2001a). Studies of the effects of deep-brain stimulation, employed as a treatment for Parkinson's disease, have observed that stimulation of the subthalamic nucleus (STN) impairs performance on tasks requiring inhibition or attentional control, including GO/NOGO, Stroop, and WM tasks, possibly through disruption of output pathways through the striatum to PFC (Hershey et al, 2004;Jahanshahi et al, 2000).…”

Section: Item-specific Versus Process-specific Effects In Working Memorymentioning

confidence: 99%

Flexible cognitive control: Effects of individual differences and brief practice on a complex cognitive task

et al. 2006

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Brain activations underlying cognitive processes are subject to modulation as a result of increasing cognitive demands, individual differences, and practice. The present study investigated these modulatory effects in a cognitive control task which required inhibition of prepotent responses based on the contents of working memory (WM) and which enabled a novel dissociation of item-specific and taskskill effects resulting from brief practice. Distinct responses in areas underlying WM and inhibitory control in the absence of behavioral changes reflected different effects of item repetition and general task practice on tonic working memory and phasic inhibitory processes. Item repetition was associated with decreases in both unique and common areas subserving WM and inhibitory control. In contrast, general task practice was reflected in decreases in the level of tonic WM activity required to maintain a consistently high level of task performance but increased activity in a number of core inhibitory regions including dorsolateral and inferior PFC and inferior parietal cortex. Furthermore, both practice and individual differences in task performance were associated with the ability to modulate and maintain activity in frontostriatal areas mediating attentional control, suggesting that the areas that differ between individuals can be modulated by practice within an individual. These results raise the possibility that a fundamental human ability, reflexive cognitive control, is amenable to practice. D

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Stimulation of STN impairs aspects of cognitive control in PD

Abstract: STN stimulation reduces working memory and response inhibition performance under conditions of greater challenge to cognitive control despite significant improvement of motor function.

Cited by 176 publications

References 44 publications

Triangulating a Cognitive Control Network Using Diffusion-Weighted Magnetic Resonance Imaging (MRI) and Functional MRI

Triangulating a Cognitive Control Network Using Diffusion-Weighted Magnetic Resonance Imaging (MRI) and Functional MRI

Compensatory stepping in Parkinson's disease is still a problem after deep brain stimulation randomized to STN or GPi

Flexible cognitive control: Effects of individual differences and brief practice on a complex cognitive task

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