Theta-frequency subthalamic nucleus stimulation increases decision threshold

Rachel C Cole; Nadja R Ging Jehli; Juan Vivanco Suarez; Jeremy D Greenlee; Jan R Wessel; Arturo I Espinoza; Johnson Zhang; James F Cavanagh; Nandakumar S Narayanan

doi:10.1016/j.brs.2025.05.105

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Theta-frequency subthalamic nucleus stimulation increases decision threshold

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Peer reviewed

Theta-frequency subthalamic nucleus stimulation increases decision threshold

Rachel C Cole, Nadja R Ging Jehli, Juan Vivanco Suarez, Jeremy D Greenlee, Jan R Wessel, Arturo I Espinoza, Johnson Zhang, James F Cavanagh and Nandakumar S Narayanan

Brain stimulation, Vol.18(4), pp.1021-1027

07/2025

DOI: 10.1016/j.brs.2025.05.105

PMCID: PMC12392301

PMID: 40374107

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Abstract

Executive functions are often impaired in patients with Parkinson's disease (PD), and these deficits can be predicted by decreased frontal cortical 4-8 Hz theta activity that is associated with cognitive control. Previous work has shown that stimulating the subthalamic nucleus (STN) at theta frequencies via deep-brain stimulation (DBS) can improve cognitive control. Here we tested the neurocomputational hypothesis that stimulating STN theta activity increases decision thresholds, supporting more deliberate responding and nuanced adaptation under task trials that require cognitive control. We tested 15 patients with PD receiving STN DBS at standard therapeutic frequencies ∼130 Hz and at 4 Hz while performing a Simon reaction-time task and applying computational diffusion decision modeling analyses to quantify the latent cognitive characteristic of response cautiousness via the well-established model parameter known as the decision threshold. This computational analyses better accounts for the speed-accuracy trade off when making deliberate choices. We found that ∼130-Hz STN DBS decreased decision thresholds in line with our prior work, and we report new results showing that 4-Hz STN DBS increased decision thresholds. These findings extend our knowledge of how the STN controls decision thresholds. Future work will study the STN's role in motor and cognitive control and how stimulating this region may modulate cognition in PD.

Details

Title: Subtitle: Theta-frequency subthalamic nucleus stimulation increases decision threshold
Creators: Rachel C Cole - University of Minnesota
Nadja R Ging Jehli
Juan Vivanco Suarez - University of Iowa, Neurosurgery
Jeremy D Greenlee - University of Iowa, Iowa Neuroscience Institute
Jan R Wessel - University of Iowa
Arturo I Espinoza - University of Iowa
Johnson Zhang - Department of Neurology, University of Iowa, Iowa City, IA, 52242
James F Cavanagh - University of New Mexico
Nandakumar S Narayanan - Department of Neurology, University of Iowa, Iowa City, IA, 52242. Electronic address: nandakumar-narayanan@uiowa.edu
Resource Type: Journal article
Publication Details: Brain stimulation, Vol.18(4), pp.1021-1027
DOI: 10.1016/j.brs.2025.05.105
PMID: 40374107
PMCID: PMC12392301
NLM abbreviation: Brain Stimul
ISSN: 1935-861X
eISSN: 1876-4754
Publisher: ELSEVIER SCIENCE INC
Language: English
Electronic publication date: 05/13/2025
Date published: 07/2025
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Neurology; Stead Family Department of Pediatrics; Psychological and Brain Sciences; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
Record Identifier: 9984822961902771

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