Deep Brain Stimulation of the Subthalamic Nucleus Modulates Reward-Related Behavior: A Systematic Review

Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an effective treatment for the motor symptoms of movement disorders including Parkinson's Disease (PD). Despite its therapeutic benefits, STN-DBS has been associated with adverse effects on mood and cognition. Specifically, apathy,...

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Main Authors: Yvan M. Vachez, Meaghan C. Creed
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-11-01
Series:Frontiers in Human Neuroscience
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fnhum.2020.578564/full
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spelling doaj-4cc3012ca1a3408782f98509c6c16fef2020-11-25T04:01:23ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612020-11-011410.3389/fnhum.2020.578564578564Deep Brain Stimulation of the Subthalamic Nucleus Modulates Reward-Related Behavior: A Systematic ReviewYvan M. Vachez0Meaghan C. Creed1Meaghan C. Creed2Department of Anesthesiology, Washington University Pain Center, Washington University School of Medicine, St. Louis, MO, United StatesDepartment of Anesthesiology, Washington University Pain Center, Washington University School of Medicine, St. Louis, MO, United StatesDepartments of Psychiatry, Neuroscience and Biomedical Engineering, Washington University School of Medicine, St. Louis, MO, United StatesDeep brain stimulation of the subthalamic nucleus (STN-DBS) is an effective treatment for the motor symptoms of movement disorders including Parkinson's Disease (PD). Despite its therapeutic benefits, STN-DBS has been associated with adverse effects on mood and cognition. Specifically, apathy, which is defined as a loss of motivation, has been reported to emerge or to worsen following STN-DBS. However, it is often challenging to disentangle the effects of STN-DBS per se from concurrent reduction of dopamine replacement therapy, from underlying PD pathology or from disease progression. To this end, pre-clinical models allow for the dissociation of each of these factors, and to establish neural substrates underlying the emergence of motivational symptoms following STN-DBS. Here, we performed a systematic analysis of rodent studies assessing the effects of STN-DBS on reward seeking, reward motivation and reward consumption across a variety of behavioral paradigms. We find that STN-DBS decreases reward seeking in the majority of experiments, and we outline how design of the behavioral task and DBS parameters can influence experimental outcomes. While an early hypothesis posited that DBS acts as a “functional lesion,” an analysis of lesions and inhibition of the STN revealed no consistent pattern on reward-related behavior. Thus, we discuss alternative mechanisms that could contribute to the amotivational effects of STN-DBS. We also argue that optogenetic-assisted circuit dissection could yield important insight into the effects of the STN on motivated behavior in health and disease. Understanding the mechanisms underlying the effects of STN-DBS on motivated behavior-will be critical for optimizing the clinical application of STN-DBS.https://www.frontiersin.org/articles/10.3389/fnhum.2020.578564/fulldeep brain stimulation (DBS)subthalamic nucleus (STN)rewardmotivationrodentoperant
collection DOAJ
language English
format Article
sources DOAJ
author Yvan M. Vachez
Meaghan C. Creed
Meaghan C. Creed
spellingShingle Yvan M. Vachez
Meaghan C. Creed
Meaghan C. Creed
Deep Brain Stimulation of the Subthalamic Nucleus Modulates Reward-Related Behavior: A Systematic Review
Frontiers in Human Neuroscience
deep brain stimulation (DBS)
subthalamic nucleus (STN)
reward
motivation
rodent
operant
author_facet Yvan M. Vachez
Meaghan C. Creed
Meaghan C. Creed
author_sort Yvan M. Vachez
title Deep Brain Stimulation of the Subthalamic Nucleus Modulates Reward-Related Behavior: A Systematic Review
title_short Deep Brain Stimulation of the Subthalamic Nucleus Modulates Reward-Related Behavior: A Systematic Review
title_full Deep Brain Stimulation of the Subthalamic Nucleus Modulates Reward-Related Behavior: A Systematic Review
title_fullStr Deep Brain Stimulation of the Subthalamic Nucleus Modulates Reward-Related Behavior: A Systematic Review
title_full_unstemmed Deep Brain Stimulation of the Subthalamic Nucleus Modulates Reward-Related Behavior: A Systematic Review
title_sort deep brain stimulation of the subthalamic nucleus modulates reward-related behavior: a systematic review
publisher Frontiers Media S.A.
series Frontiers in Human Neuroscience
issn 1662-5161
publishDate 2020-11-01
description Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an effective treatment for the motor symptoms of movement disorders including Parkinson's Disease (PD). Despite its therapeutic benefits, STN-DBS has been associated with adverse effects on mood and cognition. Specifically, apathy, which is defined as a loss of motivation, has been reported to emerge or to worsen following STN-DBS. However, it is often challenging to disentangle the effects of STN-DBS per se from concurrent reduction of dopamine replacement therapy, from underlying PD pathology or from disease progression. To this end, pre-clinical models allow for the dissociation of each of these factors, and to establish neural substrates underlying the emergence of motivational symptoms following STN-DBS. Here, we performed a systematic analysis of rodent studies assessing the effects of STN-DBS on reward seeking, reward motivation and reward consumption across a variety of behavioral paradigms. We find that STN-DBS decreases reward seeking in the majority of experiments, and we outline how design of the behavioral task and DBS parameters can influence experimental outcomes. While an early hypothesis posited that DBS acts as a “functional lesion,” an analysis of lesions and inhibition of the STN revealed no consistent pattern on reward-related behavior. Thus, we discuss alternative mechanisms that could contribute to the amotivational effects of STN-DBS. We also argue that optogenetic-assisted circuit dissection could yield important insight into the effects of the STN on motivated behavior in health and disease. Understanding the mechanisms underlying the effects of STN-DBS on motivated behavior-will be critical for optimizing the clinical application of STN-DBS.
topic deep brain stimulation (DBS)
subthalamic nucleus (STN)
reward
motivation
rodent
operant
url https://www.frontiersin.org/articles/10.3389/fnhum.2020.578564/full
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