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Modeling impulsivity and risk aversion in the subthalamic nucleus with deep brain stimulation
Valerie Voon1,2,3, Luis Manssuer3, Yi-Jie Zhao4
1Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Nature. Mental Health
|September 12, 2024
Summary
Deep brain stimulation of the subthalamic nucleus reduced risk-taking behavior and increased neural activity. This research clarifies impulsivity mechanisms and has implications for treating neuropsychiatric disorders.
Area of Science:
- Neuroscience
- Decision Science
- Computational Psychiatry
Background:
- Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a therapeutic intervention for Parkinson's disease and obsessive-compulsive disorder.
- STN stimulation can influence impulsivity and mood, with paradoxical effects on risk-taking and conflict-induced impulsivity.
- Understanding the neural mechanisms underlying STN stimulation's effects on risk evaluation is crucial for optimizing therapeutic outcomes.
Purpose of the Study:
- To investigate how acute subthalamic nucleus stimulation affects objective risk, uncertainty, and subjective physiological markers of risk during decision-making.
- To dissociate the effects of STN stimulation on different facets of impulsivity and risk-taking behavior.
- To explore the relationship between subthalamic nucleus physiology, evidence accumulation, and conflict processing under stimulation.
Main Methods:
- Utilized a card gambling task in conjunction with intracranial recordings from 25 participants.
- Employed within-subject, case-controlled acute stimulation of the right subthalamic nucleus in 15 participants.
- Analyzed objective risk, uncertainty, and subjective physiological markers, alongside subthalamic theta activity.
Main Results:
- Acute subthalamic nucleus stimulation significantly decreased risk-taking behavior (P=0.010, Cohen's d=0.72).
- Subthalamic theta activity increased significantly during stimulation (P<0.001, Cohen's d=0.72).
- Stimulation altered the relationship between subthalamic physiology and evidence accumulation, linking conflict and risk mechanisms.
Conclusions:
- Subthalamic nucleus stimulation modulates risk-taking and associated neural activity, offering insights into impulsivity heterogeneity.
- Findings suggest that stimulation-induced risk seeking involves the ventral subthalamic nucleus and its connectivity with the mesial prefrontal cortex.
- This research holds significant implications for understanding impulsivity and developing treatments for neuropsychiatric disorders.
