Review
Parkinson's Disease, the Subthalamic Nucleus, Inhibition, and Impulsivity
Marjan Jahanshahi PhD,
Ignacio Obeso PhD,
Christelle Baunez PhD,
Manuel Alegre MD, PhD,
Paul Krack MD,
Corresponding Author
Marjan Jahanshahi PhD
Cognitive Motor Neuroscience Group and Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
Correspondence to: Marjan Jahanshahi, Cognitive Motor Neuroscience Group and Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom; [email protected]Search for more papers by this authorIgnacio Obeso PhD
CINAC, HM–Puerta del Sur, Hospitales de Madrid, CEU–San Pablo University, Móstoles, Madrid, Spain
Search for more papers by this authorChristelle Baunez PhD
Basal Ganglia, Motivation and Reward' (BAGAMORE), Institut de Neurosciences de la Timone, UMR7289 CNRS and AMU (Aix Marseille Universite), Marseille, France
Search for more papers by this authorManuel Alegre MD, PhD
Neurophysiology Laboratory, Neuroscience Area, CIMA, University of Navarra, Pamplona, Spain
Search for more papers by this authorPaul Krack MD
INSERM U836, F-38000 Grenoble, France; University Grenoble Alpes, GIN, Grenoble, France, and CHU de Grenoble, Movement Disorder Unit, Grenoble, France
Search for more papers by this authorMarjan Jahanshahi PhD,
Ignacio Obeso PhD,
Christelle Baunez PhD,
Manuel Alegre MD, PhD,
Paul Krack MD,
Corresponding Author
Marjan Jahanshahi PhD
Cognitive Motor Neuroscience Group and Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, United Kingdom
Correspondence to: Marjan Jahanshahi, Cognitive Motor Neuroscience Group and Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom; [email protected]Search for more papers by this authorIgnacio Obeso PhD
CINAC, HM–Puerta del Sur, Hospitales de Madrid, CEU–San Pablo University, Móstoles, Madrid, Spain
Search for more papers by this authorChristelle Baunez PhD
Basal Ganglia, Motivation and Reward' (BAGAMORE), Institut de Neurosciences de la Timone, UMR7289 CNRS and AMU (Aix Marseille Universite), Marseille, France
Search for more papers by this authorManuel Alegre MD, PhD
Neurophysiology Laboratory, Neuroscience Area, CIMA, University of Navarra, Pamplona, Spain
Search for more papers by this authorPaul Krack MD
INSERM U836, F-38000 Grenoble, France; University Grenoble Alpes, GIN, Grenoble, France, and CHU de Grenoble, Movement Disorder Unit, Grenoble, France
Search for more papers by this authorCorrection added on 9 January 2015, after first online publication: author affiliation #2 updated.
Funding agencies: This work was supported by a grant from Departamento de Salud, Gobierno de Navarra (14/2009).
Relevant conflicts of interest/financial disclosures: Nothing to report.
Full financial disclosures and author roles may be found in the online version of this article.
ABSTRACT
Although Parkinson's disease (PD) is primarily considered a disorder of initiation of actions, patients also have deficits in inhibitory control, both in the motor and cognitive domains. Impulse control disorders, which can develop in association with dopaminergic medication in a small proportion of patients with PD, are the symptoms most commonly considered as representing inhibitory deficits. However, there is now also a body of evidence suggesting a role for the subthalamic nucleus (STN), which is ordinarily hyperactive in PD, in inhibitory control. Here, we review evidence from animal studies, imaging studies, and investigations recording STN activity intra- or perioperatively in patients with PD having surgery for DBS of the STN (STN-DBS). We also highlight relevant hypotheses about the role of the STN and consider evidence from studies that have examined the effect of STN-DBS in patients with PD on performance of experimental tasks requiring inhibition of prepotent or habitual responses or decision making under conflict, as well as the psychiatric side effects of STN-DBS. Though the results are not always consistent, nevertheless, this body of evidence supports the role of the STN in inhibitory and executive control. © 2014 International Parkinson and Movement Disorder Society
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