@article{1826bc3ef5b247d5bf8296cc17ddad1e,
title = "Increased Subthalamic Nucleus Deep Brain Stimulation Amplitude Impairs Inhibitory Control of Eye Movements in Parkinson's Disease",
abstract = "Background and Objectives: Bilateral subthalamic nucleus deep brain stimulation (STN DBS) in Parkinson's disease (PD) can have detrimental effects on eye movement inhibitory control. To investigate this detrimental effect of bilateral STN DBS, we examined the effects of manipulating STN DBS amplitude on inhibitory control during the antisaccade task. The prosaccade error rate during the antisaccade task, that is, directional errors, was indicative of impaired inhibitory control. We hypothesized that as stimulation amplitude increased, the prosaccade error rate would increase. Materials and Methods: Ten participants with bilateral STN DBS completed the antisaccade task on six different stimulation amplitudes (including zero amplitude) after a 12-hour overnight withdrawal from antiparkinsonian medication. Results: We found that the prosaccade error rate increased as stimulation amplitude increased (p < 0.01). Additionally, prosaccade error rate increased as the modeled volume of tissue activated (VTA) and STN overlap decreased, but this relationship depended on stimulation amplitude (p = 0.04). Conclusions: Our findings suggest that higher stimulation amplitude settings can be modulatory for inhibitory control. Some individual variability in the effect of stimulation amplitude can be explained by active contact location and VTA-STN overlap. Higher stimulation amplitudes are more deleterious if the active contacts fall outside of the STN resulting in a smaller VTA-STN overlap. This is clinically significant as it can inform clinical optimization of STN DBS parameters. Further studies are needed to determine stimulation amplitude effects on other aspects of cognition and whether inhibitory control deficits on the antisaccade task result in a meaningful impact on the quality of life.",
keywords = "Antisaccade, Parkinson's disease, deep brain stimulation, inhibitory control, stimulation amplitude",
author = "Munoz, {Miranda J.} and Goelz, {Lisa C.} and Pal, {Gian D.} and Karl, {Jessica A.} and Metman, {Leo Verhagen} and Sepehr Sani and Rosenow, {Joshua M.} and Ciolino, {Jody D.} and Kurani, {Ajay S.} and Corcos, {Daniel M.} and David, {Fabian J.}",
note = "Funding Information: Source(s) of financial support: This work was supported by the National Institutes of Health (R01 NS09295001, T32 NS047987, and F31 NS12069501). Funding Information: Source(s) of financial support: This work was supported by the National Institutes of Health (R01 NS09295001, T32 NS047987, and F31 NS12069501).Conflict of Interest: Dr. Pal receives research support from NINDS, Bakalar Family Foundation, and Parkinsons Foundation and is on the advisory board/consults for Asim, Huron, AbbVie, Boston Scientific, KeyQuest, Qessential, SeaGrove, Medtronic, and Abbott. Dr. Verhagen Metman receives research support from, is on the advisory board of, and consults for Abbott and AbbVie; receives research support from and consults for Boston Scientific; receives research support from and is on the advisory board for Biogen; and receives research support from Medtronic, Neuroderm, and Prilenia Therapeutics. Dr. Rosenow consults for Boston Scientific. All other authors have nothing to disclose. Funding Information: Dr. Pal receives research support from NINDS, Bakalar Family Foundation, and Parkinsons Foundation and is on the advisory board/consults for Asim, Huron, AbbVie, Boston Scientific, KeyQuest, Qessential, SeaGrove, Medtronic, and Abbott. Dr. Verhagen Metman receives research support from, is on the advisory board of, and consults for Abbott and AbbVie; receives research support from and consults for Boston Scientific; receives research support from and is on the advisory board for Biogen; and receives research support from Medtronic, Neuroderm, and Prilenia Therapeutics. Dr. Rosenow consults for Boston Scientific. All other authors have nothing to disclose. Conflict of Interest: Publisher Copyright: {\textcopyright} 2022 The Authors",
year = "2022",
month = aug,
doi = "10.1111/ner.13476",
language = "English (US)",
volume = "25",
pages = "866--876",
journal = "Neuromodulation",
issn = "1094-7159",
publisher = "Wiley-Blackwell",
number = "6",
}