Immediate Effects of Deep Brain Stimulation of Anterior Thalamic Nuclei on Executive Functions and Emotion-attention Interaction in Humans

Overview

Journal J Clin Exp Neuropsychol

Publisher Routledge

Date 2014 May 21

PMID 24839985

Citations 33

Authors

Kaisa M Hartikainen

Lihua Sun

Markus Polvivaara

Maarja Brause

Kai Lehtimaki

Joonas Haapasalo

Timo Mottonen

Kirsi Vayrynen

Keith H Ogawa

Juha Ohman

Jukka Peltola

Affiliations

Soon will be listed here.

Abstract

Background: Deep brain stimulation (DBS) of anterior thalamic nuclei (ANT) is a novel promising therapeutic method for treating refractory epilepsy. Despite reports of subjective memory impairments and mood disturbances in patients with ANT-DBS, little is known of its effects on cognitive and affective processes.

Hypothesis: The anterior thalamus has connections to prefrontal and limbic networks important for cognitive control and emotional reactivity. More specifically, anterior cingulate cortex (ACC), linked with ANT, has been assigned roles related to response inhibition and attention allocation to threat. Thus, we hypothesized ANT-DBS to influence executive functions, particularly response inhibition, and modulate emotional reactivity to threat.

Method: Twelve patients having undergone ANT-DBS for intractable epilepsy participated in the study. Patients performed a computer-based executive reaction time (RT) test--that is, a go/no-go visual discrimination task with threat-related emotional distractors and rule switching, while the DBS was switched ON (5/5 mA constant current) and OFF every few minutes.

Results: ANT-DBS increased the amount of commission errors--that is, errors where subjects failed to withhold from responding. Furthermore, ANT-DBS slowed RTs in context of threat-related distractors. When stimulation was turned off, threat-related distractors had no distinct effect on RTs.

Conclusion: We found immediate objective effects of ANT-DBS on human cognitive control and emotion-attention interaction. We suggest that ANT-DBS compromised response inhibition and enhanced attention allocation to threat due to altered functioning of neural networks that involve the DBS-target, ANT, and the regions connected to it such as ACC. The results highlight the need to consider affective and cognitive side-effects in addition to the therapeutic effect when adjusting stimulation parameters. Furthermore, this study introduces a novel window into cognitive and affective processes by modulating the associative and limbic networks with direct stimulation of key nodes in the thalamus.

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