Subthalamic nucleus stimulation affects theory of mind network: a PET study in Parkinson's disease

• Published in: PloS one Vol. 5; no. 3; p. e9919
• Main Authors: Péron, Julie, Le Jeune, Florence, Haegelen, Claire, Dondaine, Thibaut, Drapier, Dominique, Sauleau, Paul, Reymann, Jean-Michel, Drapier, Sophie, Rouaud, Tiphaine, Millet, Bruno, Vérin, Marc
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 29-03-2010; Public Library of Science (PLoS)
• Subjects: Aged; Alzheimer's disease; Alzheimers disease; Analysis; Brain; Brain damage; Brain Mapping; Case-Control Studies; Cognition; Computer networks; Correlation; Cortex; Deep Brain Stimulation; Dementia; Electrical stimuli; Emotion recognition; Emotions; Eye; Eye (anatomy); Female; Fluorodeoxyglucose F18 - pharmacology; Frontal gyrus; Glucose; Glucose - metabolism; Humans; Life Sciences; Limbic system; Limbic System - physiology; Male; Medical research; Metabolism; Middle Aged; Movement disorders; Neural networks; Neurodegenerative diseases; Neurological Disorders/Movement Disorders; Neurological Disorders/Neuroimaging; Neuroscience/Cognitive Neuroscience; Nuclei; Occipital lobe; Parietal lobe; Parkinson Disease - diagnosis; Parkinson Disease - pathology; Parkinson's disease; Parkinsons disease; Patients; Physiological aspects; Positron emission; Positron emission tomography; Positron-Emission Tomography - methods; Solitary tract nucleus; Stimulation; Subthalamic nucleus; Subthalamic Nucleus - metabolism; Superior temporal gyrus; Surgery; Temporal gyrus; Temporal lobe; Theory; Tomography; Visual tasks; France
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0009919

There appears to be an overlap between the limbic system, which is modulated by subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson's disease (PD), and the brain network that mediates theory of mind (ToM). Accordingly, the aim of the present study was to investigate the effects of STN DBS on ToM of PD patients and to correlate ToM modifications with changes in glucose metabolism.
To this end, we conducted (18)FDG-PET scans in 13 PD patients in pre- and post-STN DBS conditions and correlated changes in their glucose metabolism with modified performances on the Eyes test, a visual ToM task requiring them to describe thoughts or feelings conveyed by photographs of the eye region. Postoperative PD performances on this emotion recognition task were significantly worse than either preoperative PD performances or those of healthy controls (HC), whereas there was no significant difference between preoperative PD and HC. Conversely, PD patients in the postoperative condition performed within the normal range on the gender attribution task included in the Eyes test. As far as the metabolic results are concerned, there were correlations between decreased cerebral glucose metabolism and impaired ToM in several cortical areas: the bilateral cingulate gyrus (BA 31), right middle frontal gyrus (BA 8, 9 and 10), left middle frontal gyrus (BA 6), temporal lobe (fusiform gyrus, BA 20), bilateral parietal lobe (right BA 3 and right and left BA 7) and bilateral occipital lobe (BA 19). There were also correlations between increased cerebral glucose metabolism and impaired ToM in the left superior temporal gyrus (BA 22), left inferior frontal gyrus (BA 13 and BA 47) and right inferior frontal gyrus (BA 47). All these structures overlap with the brain network that mediates ToM.
These results seem to confirm that STN DBS hinders the ability to infer the mental states of others and modulates a distributed network known to subtend ToM.