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From the Departments of Psychiatry (Dr. Hershey), Neurology (Drs. Hershey, Revilla, and Perlmutter, A. Wernle and P. Schneider Gibson), Neurological Surgery (Drs. Revilla and Dowling), Radiology (Dr. Perlmutter), and Anatomy and Neurobiology (Dr. Perlmutter) and Program in Physical Therapy (Dr. Perlmutter), Washington University School of Medicine, St Louis, MO.
Address correspondence and reprint requests to Dr. T. Hershey, Washington University School of Medicine, Campus Box 8225, 4525 Scott Ave., St. Louis, MO 63110; e-mail: tammy{at}npg.wustl.edu
Objective: To test the hypothesis that subthalamic nucleus (STN) stimulation in Parkinson disease (PD) patients affects working memory and response inhibition performance, particularly under conditions of high demand on cognitive control.
Methods: To test this hypothesis, spatial working memory (spatial delayed response [SDR]) and response inhibition (Go–No–Go [GNG]) tasks requiring varying levels of cognitive control were administered to patients with PD with previously implanted bilateral STN stimulators (n = 24). Patients did not take PD medications overnight. Data were collected while bilateral stimulators were on and off, counterbalancing the order across subjects.
Results: On the SDR task, STN stimulation decreased patients’ working memory performance under a high but not low memory load condition (effect of stimulator condition on high load only and condition x load interaction, p < 0.05). On the GNG task, STN stimulation reduced discriminability on a high but not medium inhibition condition (effect of stimulator condition on high inhibition level only, p = 0.05; condition x inhibition level interaction, p = 0.07).
Conclusion: STN stimulation reduces working memory and response inhibition performance under conditions of greater challenge to cognitive control despite significant improvement of motor function.
Received September 10, 2003. Accepted in final form December 11, 2003.
Dr. Revilla received partial fellowship funding in excess of $10,000 from Medtronic, the manufacturer of the implanted stimulators. Dr. Dowling has acted as a paid consultant for Medtronic.
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