Deep brain stimulation of the nucleus accumbens releases aversive inhibition of behaviour in obsessive-compulsive disorder

  1. JJ González Rosa
  2. JC Swart
  3. F. Lopez-Sosa
  4. S. Treu
  5. JA Barcía
  6. R. Cools
  7. BA Strange
  8. HEM den Ouden
Libro:
To go or not to go? On motivational biases in decision making

Editorial: Radboud University - Donders Series

ISBN: 9789462841734

Año de publicación: 2019

Páginas: 137-162

Tipo: Capítulo de Libro

GOOGLE SCHOLAR lock_openAcceso abierto editor

Resumen

The striatum has long been implicated in motivation, learning, and action. Recent theorieshave proposed that the striatum is particularly involved in the coupling of these processes,giving rise to motivational biases in the selection and learning of actions. Here we assess thecausal role of the ventral striatum in the motivational biasing of action for the first time inhumans by directly stimulating the nucleus accumbens with deep brain stimulation (DBS).Treatment-refractory obsessive-compulsive disorder patients (n=8) performed a motivationalGo/NoGo task with concurrent EEG recordings. The subjects needed to learn to make Go orNoGo responses in order to win reward or avoid punishment, while DBS was switched ONvs. OFF in a cross-over within-subject design. As previously observed in healthy populations,performance was strongly affected by the cue valence, such that fewer and slower Go responseswere made when avoiding punishment than when playing for reward. DBS attenuated theinhibitory influence of punishment cues on reaction times and marginally on the proportionGo responses when Go responses were required. For the Go cues where these Pavlovianresponse tendencies conflicted with the instrumental requirements, oscillatory theta (4-8Hz)activity increased over the midfrontal cortex. These putative conflict-related midfrontal thetaresponses were not significantly affected by DBS. Taken together, these results suggest thatnucleus accumbens stimulation attenuates the motivational biasing of action, seeminglywithout affecting frontal control systems. These results causally implicate the human nucleusaccumbens in the coupling of motivation and behavioural activation