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Subthalamic nucleus stimulation affects incentive salience attribution in Parkinson's disease§

Authors

  • Tereza Serranová MD,

    Corresponding author
    1. Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
    • Department of Neurology, First Medical Faculty, Charles University in Prague, Kateřinská 30, 120 00, Praha 2, Czech Republic
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  • Robert Jech MD,

    1. Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
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  • Petr Dušek MD,

    1. Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
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  • Tomáš Sieger,

    1. Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
    2. Department of Cybernetics, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic
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  • Filip Růžička MD,

    1. Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
    2. Department of Neurosurgery, Na Homolce Hospital, Prague, Czech Republic
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  • Dušan Urgošík MD,

    1. Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
    2. Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic
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  • Evžen Růžička MD

    1. Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
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  • Funding agencies: This work was supported by the Czech Science Foundation (grant project 309/09/1145) and by the Czech Ministry of Education (research project MŠM 0021620849).

  • Relevant conflicts of interest/financial disclosures: All authors received grant support from the Czech Science Foundation (309/09/1145) and the Czech Ministry of Education (MŠM 0021620849). Robert Jech, Dušan Urgošík, and Evžen Růžička received consulting fees from Medtronic.

  • §

    Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) can induce nonmotor side effects such as behavioral and mood disturbances or body weight gain in Parkinson's disease (PD) patients. We hypothesized that some of these problems could be related to an altered attribution of incentive salience (ie, emotional relevance) to rewarding and aversive stimuli. Twenty PD patients (all men; mean age ± SD, 58.3 ± 6 years) in bilateral STN DBS switched ON and OFF conditions and 18 matched controls rated pictures selected from the International Affective Picture System according to emotional valence (unpleasantness/pleasantness) and arousal on 2 independent visual scales ranging from 1 to 9. Eighty-four pictures depicting primary rewarding (erotica and food) and aversive fearful (victims and threat) and neutral stimuli were selected for this study. In the STN DBS ON condition, the PD patients attributed lower valence scores to the aversive pictures compared with the OFF condition (P < .01) and compared with controls (P < .01). The difference between the OFF condition and controls was less pronounced (P < .05). Furthermore, postoperative weight gain correlated with arousal ratings from the food pictures in the STN DBS ON condition (P < .05 compensated for OFF condition). Our results suggest that STN DBS increases activation of the aversive motivational system so that more relevance is attributed to aversive fearful stimuli. In addition, STN DBS–related sensitivity to food reward stimuli cues might drive DBS-treated patients to higher food intake and subsequent weight gain. © 2011 Movement Disorder Society

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