Evidence map›Paper›PMID 39749399›Full record

ArticleMovement disorders clinical practice2025

Impulse Control Disorders and Effort-Based Decision-Making in Parkinson's Disease Patients with Subthalamic Nucleus Deep Brain Stimulation.

Deborah Amstutz, Katrin Petermann, Mario Sousa, Ines Debove, Marie Elise Maradan-Gachet, Lena C Bruhin, Andreia D Magalhães, Gerd Tinkhauser, Andreas Diamantaras, Julia Waskönig and 6 more

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In one paragraph

Article in Movement disorders clinical practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Deborah AmstutzDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0003-2268-8021
Katrin PetermannGraduate School for Health Sciences, University of Bern, Bern, Switzerland.
Mario SousaDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Ines DeboveDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0002-1709-2963
Marie Elise Maradan-GachetDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Lena C BruhinARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Andreia D MagalhãesGraduate School for Health Sciences, University of Bern, Bern, Switzerland.
Gerd TinkhauserDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Andreas DiamantarasDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Julia WaskönigDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Lenard Martin LachenmayerDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Claudio PolloDepartment of Neurosurgery, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
Dario CazzoliARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Tobias NefARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Masud HusainNuffield Department of Clinical Neurosciences, Oxford University, Oxford, United Kingdom.
Paul KrackDepartment of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.

Funding

Parkinson Schweiz
6 · The paper itself

Abstract

backgroundImpulse control disorders (ICD) are common side effects of dopaminergic treatment in Parkinson's disease (PD). Whereas some studies show a reduction in ICD after subthalamic nucleus deep brain stimulation (STN-DBS), others report worsening of ICD or impulsivity.

objectiveThe aim was to study ICD in the context of STN-DBS using an objective measure of decision-making.

methodsTen PD patients performed an effort-based decision-making task alongside neuropsychiatric and cognitive evaluation before and 4 months after STN-DBS. Further, 33 PD patients underwent the same experimental procedures just once after an average 40 months of chronic STN-DBS. Participants were examined preoperatively in the medication on state and postoperatively in the medication on/stimulation ON state. Mixed linear models were used to assess the impact of ICD and STN-DBS on acceptance rate and decision time in the task while controlling for motor symptom burden, cognitive measures, and dopaminergic medication.

resultsResults revealed an increased willingness to exert high levels of effort in return for reward in patients with ICD, but acceptance rate was not modulated by chronic STN-DBS. Further, ICD, cognitive processing speed, and STN-DBS were all identified as positive predictors for faster decision speed. ICD scores showed a tendency to improve 4 months after STN-DBS, without an increase in apathy scores.

conclusionsChronic STN-DBS and ICD facilitate effort-based decision-making by speeding up judgment. Furthermore, ICD enhances the willingness to exert high levels of effort for reward. Both STN-DBS and dopaminergic medication impact motivated behavior and should be titrated carefully to balance neuropsychiatric symptoms.

Indexed as

Decision MakingDeep Brain StimulationDisruptive, Impulse Control, and Conduct DisordersParkinson DiseaseSubthalamic NucleusAgedFemaleHumansMaleMiddle AgedNeuropsychological Testsdeep brain stimulationeffort‐based decision‐makingimpulse control disordersneuropsychiatric symptomsParkinson's disease

Identifiers

PMID39749399
PMCPMC11998690

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.