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. 2019 Jan 2:2019:3604372.
doi: 10.1155/2019/3604372. eCollection 2019.

Enhanced Motivational Modulation of Motor Behaviour with Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease

Maja Kojovic  1   2 , Andrea Higgins  2   3   4 , Pablo Mir  2   5   6 , Marjan Jahanshahi  2   7
Affiliations

Enhanced Motivational Modulation of Motor Behaviour with Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease

Maja Kojovic et al. Parkinsons Dis. .

Abstract

Background: Motivational improvement of movement speed in Parkinson's disease (PD) is observed in life-threatening situations and has been empirically demonstrated in experimental studies using reaction time paradigms.

Objectives: To address two clinically relevant questions: first, if in PD, motivational modulation through provision of monetary incentive on a sorting task that approximates performance on everyday life tasks affects movement speed. Second, how this effect is compared between PD patients treated with medication or subthalamic deep brain stimulation.

Methods: We used the Card Arranging Reward Responsivity Objective Test that shares component processes with everyday life tasks to compare reward responsivity of movement speed in 10 PD patients with STN-DBS, 10 nonoperated medicated PD patients, both OFF and ON their usual medications/stimulation, and 11 age-matched healthy controls.

Results: Despite longer disease duration and more severe motor symptoms, STN-DBS PD patients with the stimulator turned ON showed greater improvement of movement speed with the prospect of monetary incentive compared to both medicated PD patients and healthy participants.

Discussion: The effect of monetary incentive on movement speed in PD patients is more pronounced with STN-DBS than dopaminergic medications, suggesting that motivational modulation of movement speed may be enhanced as a direct consequence of STN stimulation.

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Figures

Figure 1
Figure 1
Nonrewarded speed (NREWSPEED) in T2 and rewarded speed (REWSPEED) in T3 are showed for STN-DBS PD patients and MED PD patients in OFF and ON conditions and for first and second experiments for healthy participants. The slope represents RRI, that is, REWSPEED−NRSPEED. PD patients with STN-DBS ON have higher RRI compared to medicated PD patients ON (p=0.03) and to healthy participants (p=0.03).
See this image and copyright information in PMC

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