Hold Your Horses: Impulsivity, Deep Brain Stimulation, and Medication in Parkinsonism

@article{Frank2007HoldYH,
  title={Hold Your Horses: Impulsivity, Deep Brain Stimulation, and Medication in Parkinsonism},
  author={Michael J. Frank and Johan Samanta and Ahmed A. Moustafa and Scott J. Sherman},
  journal={Science},
  year={2007},
  volume={318},
  pages={1309 - 1312}
}
Deep brain stimulation (DBS) of the subthalamic nucleus markedly improves the motor symptoms of Parkinson's disease, but causes cognitive side effects such as impulsivity. We showed that DBS selectively interferes with the normal ability to slow down when faced with decision conflict. While on DBS, patients actually sped up their decisions under high-conflict conditions. This form of impulsivity was not affected by dopaminergic medication status. Instead, medication impaired patients' ability… 
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The results show that not all impulsivities are detrimentally affected by DBS of the STN and that the joint use of experimental paradigms and psychological questionnaires can provide useful insights in the study of impulsivity.
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    The Journal of neuropsychiatry and clinical neurosciences
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TLDR
A paradigm that considers stimulation effects and dopamine replacement therapy to be key drivers of postoperative neuropsychiatric problems is presented.
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TLDR
It is found that inhibitory control is improved only when both DBS are active, that is, the reaction time to the stop signal is significantly shorter in the DBS-ON condition than in all the others, and STN seems to play a selective role in response inhibition.
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The subthalamic nucleus (STN), which is currently the most common target for deep brain stimulation (DBS) for Parkinson's disease (PD), has received increased attention over the past few years for…
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Differences between individuals' ability to inhibit inappropriate responses may underlie both the normal variation in trait impulsivity in the healthy population, as well as the pathological compulsions experienced by those with impulse control disorders (ICDs).
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