Subthalamic Nucleus Stimulation Modulates Cognitive Theory of Mind in Parkinson's Disease

Author:

Xiao Haoyun12ORCID,Lang Liqin3,Ye Zheng1ORCID,Wu Jianjun4ORCID

Affiliation:

1. Institute of Neuroscience, Center for Excellence in Brain Science and Intelligence Technology Chinese Academy of Sciences Shanghai China

2. University of Chinese Academy of Sciences Beijing China

3. Department of Neurology and National Research Center for Aging and Medicine and National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital Fudan University Shanghai China

4. Department of Neurology, Huashan Hospital Fudan University Shanghai China

Abstract

AbstractBackgroundTheory of mind (ToM), the ability to infer others' mental state, is essential for social interaction among human beings. It has been widely reported that both cognitive (inference of knowledge) and affective (inference of emotion) components of ToM are disrupted in Parkinson's disease (PD). Previous studies usually focused on the involvement of the prefrontal cortex.ObjectiveThis study investigated the causal role of the subthalamic nucleus (STN), a key hub of the fronto‐basal ganglia loops, in ToM.MethodsThirty‐four patients with idiopathic PD (15 women, aged 62.2 ± 8.3 years) completed a Yoni task with deep brain stimulation (DBS) ON and OFF. The Yoni task was designed to separate the cognitive and affective components of ToM. Volumes of tissue activated (VTA) were computed for three subregions of the STN.ResultsDBS showed insignificant effects on ToM inference costs at the group level, which may be due to the large interindividual variability. The associative VTA correlated with the cognitive inference cost change but not the affective inference cost change. Patients with greater associative STN stimulation infer more slowly on cognitive ToM. Stimulating associative STN can adversely affect cognitive ToM in PD patients, especially in patients with a wide range of stimulation (≥0.157) or cognitive decline (Montreal Cognitive Assessment < 26).ConclusionsThe associative STN plays a causal role in cognitive ToM in patients with PD. However, stimulating the associative STN likely impairs cognitive ToM and potentially leads to social interaction deficits in PD. © 2024 International Parkinson and Movement Disorder Society.

Funder

National Health Commission of the People's Republic of China

National Natural Science Foundation of China

Publisher

Wiley

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