BACKGROUND: The cognitive role of the subthalamic nucleus (STN) remains largely unknown. METHODS/RESULTS: A modified protocol with a dual task elicited local field event-related potentials (ERPs) within the STN. No generators of ERPs were elicited by the standard oddball protocol in the STN (at variance with recordings from the putamen, caudate and pallidum). Repetitive transcranial magnetic stimulation (rTMS) over the right inferior frontal cortex caused a shortening of latencies of ERPs in standard and dual protocols. No changes were observable after the rTMS over the dorsolateral prefrontal cortex and sham stimulation. In the STN, only the tasks with an increased demand on executive functions produced the alpha-/beta-event-related desynchronization/synchronization in visuomotor tasks with single letters writing. CONCLUSION: Our results indicate a specific, task-related involvement of the STN in the cognitive activities. Cognitive processing in the STN is possibly processed via hyperdirect cortico-STN pathway. Certain effects of deep brain stimulation surgery on cognitive performance could be explained by a direct effect on 'cognitive' parts of the STN.

• MeSH
• akustická stimulace metody   MeSH
• biofyzika MeSH
• elektroencefalografie metody   MeSH
• elektromyografie metody   MeSH
• evokované potenciály fyziologie   MeSH
• funkční lateralita MeSH
• kognice fyziologie   MeSH
• lidé MeSH
• neuropsychologické testy MeSH
• nucleus subthalamicus patofyziologie   MeSH
• Parkinsonova nemoc komplikace   patologie   terapie   MeSH
• periodicita MeSH
• psychoakustika MeSH
• transkraniální magnetická stimulace metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• práce podpořená grantem MeSH

Although deep brain stimulation of the subthalamic nucleus (STN-DBS) in Parkinson's disease (PD) is generally a successful therapy, adverse events and insufficient clinical effect can complicate the treatment in some patients. We studied clinical parameters and cortical oscillations related to STN-DBS to identify patients with suboptimal responses. High-density EEG was recorded during a visual oddball three-stimuli paradigm in DBS "off" and "on" conditions in 32 PD patients with STN-DBS. Pre-processed data were reconstructed into the source space and the time-frequency analysis was evaluated. We identified a subgroup of six patients with longer reaction times (RT) during the DBS "on" state than in the DBS "off" state after target stimuli. These subjects had lower motor responsiveness to DBS and decreased memory test results compared to the other subjects. Moreover, the alpha and beta power decrease (event-related desynchronizations, ERD), known as an activation correlate linked to motor and cognitive processing, was also reduced in the DBS "on" condition in these patients. A subgroup of PD patients with a suboptimal response to STN-DBS was identified. Evaluation of RT could potentially serve as a biomarker for responsiveness to STN-DBS.

• MeSH
• hluboká mozková stimulace * MeSH
• kognice MeSH
• lidé MeSH
• nucleus subthalamicus * MeSH
• Parkinsonova nemoc * terapie   MeSH
• reakční čas MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH