Science · 2007 · 1.1K citations · 28 references
Life SciencesNeurologyNeuroscienceBehavioral NeuroscienceCognitive NeuroscienceNeuropharmacologyBasal GangliaBasal Ganglia PhysiologyDecision-making ModelsDeep Brain StimulationNeuromodulationParkinson DiseaseBasal Ganglia FunctionBasal Ganglia Motor ControlCognitive EffectsDecision Under ConflictDecision-making ConflictDecision-making Under ConflictDeep Brain Stimulation EffectsSubthalamic Nucleus Physiology
Deep brain stimulation of the subthalamic nucleus improves motor symptoms in Parkinson’s disease but can induce cognitive side effects such as impulsivity. DBS disrupts the ability to slow decisions under conflict, causing patients to speed up high‑conflict choices—a form of impulsivity that is independent of dopaminergic medication—while medication impairs learning from negative outcomes, indicating separate mechanisms for impulsivity as predicted by a basal‑ganglia computational model.
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 to learn from negative decision outcomes. These findings implicate independent mechanisms leading to impulsivity in treated Parkinson's patients and were predicted by a single neurocomputational model of the basal ganglia.
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Conflict monitoring versus selection-for-action in anterior cingulate cortex
Matthew Botvinick, Leigh E. Nystrom, Kate Fissell et al. · Nature · 1999 · 2.1K citations