Subthalamic stimulation causally modulates human voluntary decision-making to stay or go.

IF 6.7 1区 医学 Q1 NEUROSCIENCES NPJ Parkinson's Disease Pub Date : 2024-11-02 DOI:10.1038/s41531-024-00807-x
Yichen Wang, Linbin Wang, Luis Manssuer, Yi-Jie Zhao, Qiong Ding, Yixin Pan, Peng Huang, Dianyou Li, Valerie Voon
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Abstract

The voluntary nature of decision-making is fundamental to human behavior. The subthalamic nucleus is important in reactive decision-making, but its role in voluntary decision-making remains unclear. We recorded from deep brain stimulation subthalamic electrodes time-locked with acute stimulation using a Go/Nogo task to assess voluntary action and inaction. Beta oscillations during voluntary decision-making were temporally dissociated from motor function. Parkinson's patients showed an inaction bias with high beta and intermediate physiological states. Stimulation reversed the inaction bias highlighting its causal nature, and shifting physiology closer to reactive choices. Depression was associated with higher alpha during Voluntary-Nogo characterized by inaction or inertial status quo maintenance whereas apathy had higher beta-gamma during voluntary action or impaired effortful initiation of action. Our findings suggest the human subthalamic nucleus causally contributes to voluntary decision-making, possibly through threshold gating or toggling mechanisms, with stimulation shifting towards voluntary action and suggest biomarkers as potential clinical predictors.

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刺激丘脑下部可调节人类的去留自主决策。
决策的自愿性是人类行为的基础。丘脑下核在反应性决策中非常重要,但它在自愿决策中的作用仍不清楚。我们使用 Go/Nogo 任务记录了与急性刺激时间锁定的脑深部刺激丘下电极,以评估自主行动和不行动。自主决策过程中的β振荡在时间上与运动功能分离。帕金森病患者表现出高β和中间生理状态下的不作为偏差。刺激可逆转不作为偏差,突出其因果性质,并使生理状态更接近于反应性选择。抑郁症患者在自愿-Nogo过程中具有较高的α值,其特征是不行动或惯性维持现状,而冷漠症患者在自愿行动过程中具有较高的β-γ值,或行动的努力启动受损。我们的研究结果表明,人类丘脑下核可能通过阈值门控或切换机制对自主决策有因果关系,刺激转向自主行动,并建议将生物标志物作为潜在的临床预测指标。
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来源期刊
NPJ Parkinson's Disease
NPJ Parkinson's Disease Medicine-Neurology (clinical)
CiteScore
9.80
自引率
5.70%
发文量
156
审稿时长
11 weeks
期刊介绍: npj Parkinson's Disease is a comprehensive open access journal that covers a wide range of research areas related to Parkinson's disease. It publishes original studies in basic science, translational research, and clinical investigations. The journal is dedicated to advancing our understanding of Parkinson's disease by exploring various aspects such as anatomy, etiology, genetics, cellular and molecular physiology, neurophysiology, epidemiology, and therapeutic development. By providing free and immediate access to the scientific and Parkinson's disease community, npj Parkinson's Disease promotes collaboration and knowledge sharing among researchers and healthcare professionals.
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