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Originally published in Science Express on 25 October 2007
Science 23 November 2007:
Vol. 318. no. 5854, pp. 1309 - 1312
DOI: 10.1126/science.1146157
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Reports

Hold Your Horses: Impulsivity, Deep Brain Stimulation, and Medication in Parkinsonism

Michael J. Frank,1* Johan Samanta,2,3 Ahmed A. Moustafa,1 Scott J. Sherman3

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.

1 Department of Psychology and Program in Neuroscience, University of Arizona, Tucson, AZ 85721, USA.
2 Banner Good Samaritan Medical Center, Phoenix, AZ 85004, USA.
3 Department of Neurology, University of Arizona, Tucson, AZ 85724, USA.

* To whom correspondence should be addressed. E-mail: mfrank{at}u.arizona.edu

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