Deep Brain Stimulation of the Subthalamic Nucleus Selectively Improves Learning of Weakly Associated Cue Combinations During Probabilistic Classification Learning in Parkinson's Disease

Objective: Evidence from functional imaging and clinical studies on patients with Parkinson's disease (PD) or Huntington's disease (HD) suggests that the basal ganglia play a crucial role in learning on the weather prediction task (WPT). Using deep brain stimulation (DBS) on versus off methodology, the aim of this study was to investigate the effect of altering the output from the basal ganglia to the prefrontal cortex on implicit probabilistic classification learning on the WPT by patients with PD.

Method: Eleven PD patients with bilateral DBS of the subthalamic nucleus (STN) and 13 matched controls completed 200 trials of the WPT on 2 separate occasions, with the patients tested with DBS of the STN on or off.

Results: DBS of the STN had no effect on overall WPT learning. However, STN DBS selectively improved implicit learning of cue combinations that were weakly (implicitly), rather than strongly (explicitly), associated with the WPT outcome.

Conclusions: Results suggest that the STN plays a role in implicit probabilistic classification learning by altering basal ganglia output to the frontal cortex.