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Parkinson's D isease, the S ubthalamic N ucleus, I nhibition, and I mpulsivity
Author(s) -
Jahanshahi Marjan,
Obeso Ignacio,
Baunez Christelle,
Alegre Manuel,
Krack Paul
Publication year - 2015
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.26049
Subject(s) - parkinson's disease , subthalamic nucleus , dopaminergic , inhibitory postsynaptic potential , neuroscience , psychology , cognition , impulse control , motor symptoms , inhibitory control , motor control , disease , medicine , dopamine , deep brain stimulation
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