Evens Ricarda, Stankevich Yuliya, Dshemuchadse Maja, Storch Alexander, Wolz Martin, Reichmann Heinz, Schlaepfer Thomas E, Goschke Thomas, Lueken Ulrike
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
Neuropsychologia. 2015 Aug;75:11-9. doi: 10.1016/j.neuropsychologia.2015.05.005. Epub 2015 May 12.
Due to its position in cortico-subthalamic and cortico-striatal pathways, the subthalamic nucleus (STN) is considered to play a crucial role not only in motor, but also in cognitive and motivational functions. In the present study we aimed to characterize how different aspects of reward processing are affected by disease and deep brain stimulation of the STN (DBS-STN) in patients with idiopathic Parkinson's disease (PD).
We compared 33 PD patients treated with DBS-STN under best medical treatment (DBS-on, medication-on) to 33 PD patients without DBS, but optimized pharmacological treatment and 34 age-matched healthy controls. We then investigated DBS-STN effects using a postoperative stimulation-on/ -off design. The task set included a delay discounting task, a task to assess changes in incentive salience attribution, and the Iowa Gambling Task.
The presence of PD was associated with increased incentive salience attribution and devaluation of delayed rewards. Acute DBS-STN increased risky choices in the Iowa Gambling Task under DBS-on condition, but did not further affect incentive salience attribution or the evaluation of delayed rewards.
Findings indicate that acute DBS-STN affects specific aspects of reward processing, including the weighting of gains and losses, while larger-scale effects of disease or medication are predominant in others reward-related functions.
由于底丘脑核（STN）在皮质-底丘脑和皮质-纹状体通路中的位置，它不仅被认为在运动功能中起关键作用，而且在认知和动机功能中也起关键作用。在本研究中，我们旨在描述特发性帕金森病（PD）患者中，疾病和STN深部脑刺激（DBS-STN）如何影响奖励处理的不同方面。
我们将33例接受最佳药物治疗的DBS-STN治疗的PD患者（DBS开启，药物治疗开启）与33例未接受DBS但接受优化药物治疗的PD患者以及34例年龄匹配的健康对照进行比较。然后，我们使用术后刺激开启/关闭设计研究DBS-STN的效果。任务集包括延迟折扣任务、评估动机显著性归因变化的任务以及爱荷华赌博任务。
PD的存在与动机显著性归因增加和延迟奖励贬值有关。急性DBS-STN在DBS开启条件下增加了爱荷华赌博任务中的风险选择，但没有进一步影响动机显著性归因或延迟奖励的评估。
研究结果表明，急性DBS-STN会影响奖励处理的特定方面，包括收益和损失的权重，而疾病或药物的更大规模影响在其他与奖励相关的功能中占主导地位。
