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Published Online October 25, 2007
Science DOI: 10.1126/science.1146157

Reports

Submitted on June 6, 2007
Accepted on October 15, 2007

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

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

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

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

Deep brain stimulation (DBS) of the subthalamic nucleus dramatically improves the motor symptoms of Parkinson’s disease, but causes cognitive side effects such as impulsivity. Here we show that DBS selectively interferes with the normal ability to slow down when faced with decision conflict. While on DBS, patients actually sped up 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.


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