- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT06899022
Oppmerksomhet og øyebevegelse ved Parkinsons sykdom
Undersøker rollen som oppmerksomhet i perseptuelle og kognitive konsekvenser av Parkinsons sykdom
Målet med denne observasjonelle og intervensjonelle studien er å forstå hvordan terapeutisk dyp hjernestimulering (DBS) påvirker oppmerksomhet, persepsjon og kognisjon hos deltakere med Parkinsons sykdom (PD) og Essential Tremor (ET). De viktigste spørsmålene det tar sikte på å svare på er:
- Forandrer nedsatt kontroll av oppmerksomhet og øyebevegelse i PD hvordan sosiale signaler blir oppfattet og tolket?
- Forbedrer eller forverrer terapeutiske DB -er oppmerksomhets- og perseptuelle mangler for sosiale signaler i PD og ET?
- Kan DB -er optimaliseres for å gjenopprette normal oppmerksomhetskontroll i PD mens den forblir en effektiv terapi for andre aspekter av lidelsen.
- Hva bidrar deler av hjernen målrettet av DBS til kontroll av oppmerksomhet?
Ved å bruke et øyesporingskamera, vil etterforskerne studere hvordan deltakere med PD og ET ser på og oppfatter ansiktsuttrykk for følelser før og etter å ha startet DBS -terapi, sammenlignet med en gruppe friske deltakere uten ET, PD eller DBS. Deltakere med PD og ET vil se og vurdere forkynte ansiktsuttrykk på en dataskjerm under tre forhold:
- Før du starter DBS -terapi (over omtrent 1 time).
- I operasjonsrommet, under standardprosedyren for å implantisere DBS -elektroder, mens deltakeren er våken (i ikke mer enn 15 minutter).
- Etter å ha startet DBS -terapi, med korte eksperimentelle endringer av DBS -stimuleringsnivå og frekvens (over omtrent 1 time).
Studieoversikt
Status
Intervensjon / Behandling
Detaljert beskrivelse
Parkinsons sykdom (PD) er den nest vanligste aldersrelaterte nevrodegenerative lidelsen, med omtrent 90 000 nye tilfeller diagnostisert årlig i Nord-Amerika. Selv om motoriske symptomer definerer lidelsen, fører PD også til kognitive og emosjonelle endringer, for eksempel vanskeligheter med å gjenkjenne ansiktsuttrykk og regulere oppmerksomhet, som ofte overskygger motoriske problemer når sykdommen utvikler seg. Målet med denne studien er å bedre forstå koblingen mellom oppmerksomhet, øyebevegelse og emosjonell oppfatning i PD, teste hypotesen som forstyrret oppmerksomheten fører til endret oppfatning av ansiktsfølelser. Studien vil også undersøke hvordan dyp hjernestimulering (DBS) av den subthalamiske kjernen (STN) påvirker disse prosessene, og gir kritisk innsikt i de kognitive og perseptuelle konsekvensene av behandlingen.
Denne forskningen tar for seg et kritisk gap i å forstå ikke-motoriske symptomer på Parkinsons sykdom ved å utforske hvordan oppmerksomhet, øyebevegelse og persepsjon samhandler. Funn vil gi bevis på om kognitive og emosjonelle symptomer i PD stammer fra nedsatt oppmerksomhetskontroll, og tilbyr en ny ramme for behandling av disse underskuddene. I tillegg vil studien kaste lys over hvordan forskjellige DBS-frekvenser påvirker persepsjon og kognisjon, og potensielt veileder personaliserte stimuleringsstrategier for å lindre både motoriske og ikke-motoriske symptomer. Innsikten som er oppnådd kan påvirke fremtidige terapier for PD, og fremme både vitenskapelig kunnskap og pasientbehandling.
Deltakerne vil bli delt inn i tre grupper: PD som gjennomgår DBS, Essential Tremor (ET) som gjennomgår DBS (som en sammenligningsgruppe for ikke-PD DBS-effekter) og sunne alders- og kjønnsmatchede kontroller. Deltakerne vil fullføre ansiktsoppgaver med Morph Rating (Rating Faces som glade, nøytrale eller triste) og visuelle søkeoppgaver (finne ansikter blant distraherende), mens øyebevegelsene deres spores.
Det første studiemålet er å måle hvordan endret oppmerksomhet påvirker ansikts følelsesoppfatning i PD ved å spore øyebevegelser mens deltakerne ser på og kategoriserer emosjonelle ansiktsstimuli. Det andre målet er å karakterisere hjerneaktivitet i STN relatert til oppmerksomhets- og perseptuelle prosesser under våken DBS -kirurgi ved å fange opp mikroelektrodeopptak (MER) av nevral aktivitet mens deltakerne ser på emosjonelle ansikter, slik at forskere kan kartlegge STNs rolle i å lede oppmerksomhet og øyebevegelser. Det tredje målet er å teste hvordan DBS -stimulering ved forskjellige frekvenser (høy, lav eller AV) påvirker oppmerksomhet, øyebevegelse og emosjonell oppfatning ved å la deltakerne utføre visuelle og perseptuelle oppgaver under varierende DBS -innstillinger for å evaluere hvordan hjernestimulering påvirker kognitive og perseptuelle funksjoner.
Studietype
Registrering (Antatt)
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiekontakt
- Navn: Dulce Maroni, PhD
- Telefonnummer: 402-836-9751
- E-post: dmaroni@unmc.edu
Studer Kontakt Backup
- Navn: Christopher K Kovach, PhD
- Telefonnummer: 319-471-3372
- E-post: ckovach@unmc.edu
Studiesteder
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Nebraska
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Omaha, Nebraska, Forente stater, 68198
- Rekruttering
- University of Nebraska Medical Center
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Ta kontakt med:
- Dulce V Maroni, PhD
- Telefonnummer: 402-836-9751
- E-post: dmaroni@unmc.edu
-
Hovedetterforsker:
- Christopher K Kovach, PhD
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-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
Beskrivelse
Inkluderingskriterier
Alle deltakere (AIM 1):
- Evne og vilje til å gi signert informert samtykke for denne studien
- Evne til å uttrykke perseptuelle dommer gjennom en knappetrykk eller musekontrollert datastyrt glidebryter
- Alder 19 - 90 år
DBS -deltakere (AIM 1):
- Diagnostisering av idiopatisk Parkinsons sykdom (PD) eller Essential Tremor (ET)
- Planlagt for ny implantasjon av en terapeutisk DBS -enhet målrettet mot subthalamic nucleus (STN), ventral mellomkjernen av thalamus (VIM) eller indre globus pallidus (GPI)
Sammenligningsdeltakere (AIM 1):
o Valg etter aldersmatching til deltakere i PD Group
Parkinsons sykdom (PD) og Essential Tremor (ET) deltakere (AIM 2):
- Evne og vilje til å gi signert informert samtykke for denne studien
- Evne til å uttrykke perseptuelle dommer gjennom en knappetrykk eller musekontrollert datastyrt glidebryter
- Alder 19 - 90 år
- Planlagt for våken DBS-implantasjon med kliniske mikroelektrodeopptak (MER)
- Villig og i stand til å delta i oppgaver under en våken kirurgisk prosedyre
Parkinsons sykdom (PD) og Essential Tremor (ET) deltakere (AIM 3):
- Evne og vilje til å gi signert informert samtykke for denne studien
- Evne til å uttrykke perseptuelle dommer gjennom en knappetrykk eller musekontrollert datastyrt glidebryter
- Alder 19 - 90 år
- Villig til å gjennomgå akutte manipulasjoner av DBS
- I stand til å tolerere akutte endringer av DBS
Eksklusjonskriterier
Alle deltakere (AIM 1):
- Korrigert synsskarphet utilstrekkelig for å perceptuelt dømme ansiktsstimuli
- Manglende evne til å forstå oppgaveinstruksjoner eller fullstendige oppgavekrav
DBS -deltakere (AIM 1):
o Utilstrekkelig terapeutisk kontroll av motoriske symptomer for å delta i oppgaver som krever knappetrykk eller bruk av en mus for å kontrollere en glidebryter
Sunne sammenligningsdeltakere (AIM 1):
o Historie med nevrodegenerativ lidelse
Parkinsons sykdom (PD) og Essential Tremor (ET) deltakere (AIM 2):
- Korrigert synsskarphet utilstrekkelig for å perceptuelt dømme ansiktsstimuli
- Manglende evne til å forstå oppgaveinstruksjoner eller fullstendige oppgavekrav
- Ikke gjennomgått våken DBS -implantasjon
- Ukorrigert synsskarphet utilstrekkelig for å perceptuelt dømme ansiktsstimuli
Parkinsons sykdom (PD) og Essential Tremor (ET) deltakere (AIM 3):
- Korrigert synsskarphet utilstrekkelig for å perceptuelt dømme ansiktsstimuli
- Manglende evne til å forstå oppgaveinstruksjoner eller fullstendige oppgavekrav
- Svikt i DBS å oppnå en terapeutisk effekt på motoriske symptomer
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Grunnvitenskap
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
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Eksperimentell: Akutt endring av DBS
Alle deltakere i enkeltarmen i denne studien vil gjennomgå akutt endring av DBS -stimulering under tre forhold i randomisert rekkefølge i løpet av 1 time.
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Deltakerne vil få dyp hjernestimulering levert ved den klinisk bestemte terapeutiske frekvensen og strømmen over omtrent 20 minutter.
Deltakerne vil få dyp hjernestimulering levert ved den klinisk bestemte terapeutiske frekvensen og redusert (50%) strøm i løpet av omtrent 20 minutter.
Deltakerne vil få dyp hjernestimulering levert på den klinisk bestemte terapeutiske strømmen og reduserte (4 Hz) frekvensen over omtrent 20 minutter.
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Facial Expression Rating
Tidsramme: Baseline (within 2 weeks pre-DBS implantation), intraoperative (Day 0; day of DBS implantation surgery, and post-operative follow-up (2-3 weeks after DBS implantation, following clinical optimization of stimulation parameters).
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Participants will rate facial expression along a continuous scale using a computerized slider, following the affective bias task (ABT) of Bijanki et al. (2014).
The scale is anchored with three descriptors, "Very Sad" at slider value 0 (left), "Neutral", at position 0.5 (middle), and "Very Happy" at 1.0 (right).
Responses are compared between two time points: (1) at the initial pre-surgical testing session and post DBS implantation and (2) at the post-implantation session following clinical optimization of therapeutic parameters, 2-3 weeks after surgery.
The comparison will examine both the direction of any bias of the rating, against normative ratings, and the magnitude of average deviation from normative ratings.
Finally, the ratings will be incorporated into a generalized linear model of gaze position (Kovach 2014) to identify the association between perceived facial expression and characteristic fixation patterns.
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Baseline (within 2 weeks pre-DBS implantation), intraoperative (Day 0; day of DBS implantation surgery, and post-operative follow-up (2-3 weeks after DBS implantation, following clinical optimization of stimulation parameters).
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Eye Tracking
Tidsramme: Baseline (within 2 weeks pre-DBS implantation), intraoperative (Day 0; day of DBS implantation surgery, and post-operative follow-up (2-3 weeks after DBS implantation, following clinical optimization of stimulation parameters).
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The location and duration of gaze fixations will be recorded with a remote eye tracking camera.
The location of gaze fixations will be treated as the dependent measure within a generalized linear modeling (GLM) framework for spatial point processes, described in Kovach and Adolphs (2014).
Parameter estimates of the model give the log relative risk of fixation at different locations in the visual scene as a function of the independent measures of the model.
Independent measures include the main effect of (1) Fourier basis functions encoding scene location and its interactions with (2) image rating in the affective bias task of Bijanki et.
al (2014), (3) session and (4) DBS stimulation state.
Measures derived from the GLM model will also include the statistical deviation (e.g.
Kullback-Leibler divergence) from the average distribution of fixations observed in healthy comparison subjects for each image.
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Baseline (within 2 weeks pre-DBS implantation), intraoperative (Day 0; day of DBS implantation surgery, and post-operative follow-up (2-3 weeks after DBS implantation, following clinical optimization of stimulation parameters).
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Intraoperative Microrecordings
Tidsramme: Intraoperative (Day 0; day of DBS implantation surgery).
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During the Aim 2 portion of the study, patients undergoing awake DBS surgery as part of standard clinical care will engage in a subset of the face rating tasks during the surgery.
Invasive recordings will be obtained from DBS target structures, including STN, VIM, and GPi using microelectrodes that are placed as part of standard clinical practice.
Spike sorting will be used to identify firing of individual cells and firing rate will compared to eye movements to identify responses associated with shifts of attention in the targeted deep brain structures .
These measures will be compared across movement-disorders populations using mixed-effects linear modeling and other standard statistical procedures.
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Intraoperative (Day 0; day of DBS implantation surgery).
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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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EEG beta-band power during emotional face rating
Tidsramme: Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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Spectral power in the beta frequency band (12-30 Hz), expressed in microvolts squared (µV²) and normalized to a pre-stimulus baseline, computed from non-invasive scalp EEG over posterior electrodes during the emotional face rating component of the task.
Measurement tool: 64-channel research-grade scalp EEG with time-frequency decomposition (demodulated band transform).
Group comparisons across PD, ET, DT, and healthy controls and within-participant comparisons across DBS conditions will be made using mixed-effects linear models, comparing power at baseline and modulation of power within a -0.5 to 0.5 s peri-saccade window.
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Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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EEG event-related potential (ERP) amplitude at saccade onset
Tidsramme: Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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Mean amplitude (µV) of the stimulus-locked event-related potential at saccade onset, measured over occipito-temporal electrodes during the 100-300 ms post-stimulus interval (encompassing the N170 component).
Measurement tool: 64-channel research-grade scalp EEG with stimulus-locked averaging.
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Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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EEG beta burst rate, frequency and amplitude during emotional face viewing
Tidsramme: Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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Modulation of beta band activity (12-30 Hz), will be studied in scalp EEG recordings using a published method (Kovach 2026) for identifying oscillatory bursts based on estimation and decomposition of the fourth order spectrum (trispectrum).
Group comparisons across PD, ET, DT, and healthy controls and within-participant comparisons across DBS conditions will be made using mixed-effects linear models, comparing burst rate, amplitude and frequency comparing power at baseline and modulation of power within a -0.5 to 0.5 s peri-saccade window.
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Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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LFP beta-band (12-30 Hz) power during emotional face viewing
Tidsramme: Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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Spectral power in the beta band (12-30 Hz), expressed in microvolts squared (µV²), recorded from chronically implanted DBS electrodes targeting the subthalamic nucleus during eye-tracked task performance.
Measurement tool: voltage telemetry through clinical leads using the BrainSense capability of the Medtronic Percept implantable pulse generator.
Power will be computed via time-frequency decomposition (demodulated band transform) and compared across DBS conditions (normal therapeutic, reduced current, reduced frequency) and across movement-disorder populations using mixed-effects linear models.
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Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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LFP beta burst rate, frequency and amplitude during emotional face viewing
Tidsramme: Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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Modulation of beta band activity (12-30 Hz), will be studied in intracranial LFP recordings using a published method (Kovach et al. 2026) for identifying oscillatory bursts based on estimation and decomposition of the fourth order spectrum (trispectrum).
Group comparisons across PD, ET, DT, and healthy controls and within-participant comparisons across DBS conditions will be made using mixed-effects linear models, comparing burst rate, amplitude and frequency comparing power at baseline and modulation of power within a -0.5 to 0.5 s peri-saccade window.
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Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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LFP theta-band (4-8 Hz) power during emotional face viewing
Tidsramme: Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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Spectral power in the theta frequency band (4-8 Hz), expressed in microvolts squared (µV²) and normalized to a pre-stimulus baseline, computed from non-invasive scalp EEG over fronto-central electrodes during presentation of morphed emotional face stimuli in the affective bias task (Bijanki et al., 2014).
Measurement tool: voltage telemetry through clinical leads using the BrainSense capability of the Medtronic Percept implantable pulse generator.Group comparisons across PD, ET, DT, and healthy controls and within-participant comparisons across DBS conditions will be made using mixed-effects linear models, comparing power at baseline and modulation of power within a -0.5 to 0.5 s peri-saccade window.
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Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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EEG-LFP coherence during emotional face viewing
Tidsramme: Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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Coherence between scalp EEG recordings and intracranial LFP recordings will be examined across multiple frequencies from 1 Hz to 30 Hz using a time-frequency decomposition (demodulated band transform, Kovach 2016) with 1 Hz frequency bins.
Measurement tool: 64 channel scalp EEG and concurrent voltage telemetry through clinical leads using the BrainSense capability of the Medtronic Percept implantable pulse generator.
Group comparisons of subject-level coherence values across PD, ET, DT, and healthy controls and within-participant comparisons across DBS conditions will be made using mixed-effects linear models, comparing power at baseline and modulation of power within a -0.5 to 0.5 s peri-saccade window.
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Single experimental visit during the Aim 3 study session (third study visit; through study completion, an average of 6 months).
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Samarbeidspartnere og etterforskere
Sponsor
Samarbeidspartnere
Etterforskere
- Hovedetterforsker: Christopher K Kovach, PhD, University of Nebraska
Publikasjoner og nyttige lenker
Generelle publikasjoner
- Tottenham N, Tanaka JW, Leon AC, McCarry T, Nurse M, Hare TA, Marcus DJ, Westerlund A, Casey BJ, Nelson C. The NimStim set of facial expressions: judgments from untrained research participants. Psychiatry Res. 2009 Aug 15;168(3):242-9. doi: 10.1016/j.psychres.2008.05.006. Epub 2009 Jun 28.
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- Dorsey ER, Sherer T, Okun MS, Bloem BR. The Emerging Evidence of the Parkinson Pandemic. J Parkinsons Dis. 2018;8(s1):S3-S8. doi: 10.3233/JPD-181474.
- Shibasaki H, Tsuji S, Kuroiwa Y. Oculomotor abnormalities in Parkinson's disease. Arch Neurol. 1979 Jun;36(6):360-4. doi: 10.1001/archneur.1979.00500420070009.
- McIntyre CC, Hahn PJ. Network perspectives on the mechanisms of deep brain stimulation. Neurobiol Dis. 2010 Jun;38(3):329-37. doi: 10.1016/j.nbd.2009.09.022. Epub 2009 Oct 3.
- Sugita Y. Face perception in monkeys reared with no exposure to faces. Proc Natl Acad Sci U S A. 2008 Jan 8;105(1):394-8. doi: 10.1073/pnas.0706079105. Epub 2008 Jan 2.
- W. Penny and A. Holmes. Random effects analysis. Statistical parametric mapping: The analysis of functional brain images, 156:165, 2007.
- C. K. Kovach and M. A. Howard III. Decomposition of higher-order spectra for blind multiple-input deconvolution, pattern identification and separation. Signal Processing, 165:357-379, 2019.
- C. Kovach, J. Moreira, J. Berger, M. Howard III, L. Gwilliams, A. Fallah, L. Comstock, and E. Mendes. Higher-order spectral decomposition applied to spike sorting. Feb. 2023.
- X. Fan, M. Mocchi, B. Pascuzzi, J. Xiao, B. A. Metzger, R. K. Mathura, C. Hacker, J. A. Adkinson, E. Bartoli, S. Elhassa, et al. Brain mechanisms underlying the emotion processing bias in treatment- resistant depression. Nature Mental Health, pages 1-10, 2024.
- Metzger BA, Kalva P, Mocchi MM, Cui B, Adkinson JA, Wang Z, Mathura R, Kanja K, Gavvala J, Krishnan V, Lin L, Maheshwari A, Shofty B, Magnotti JF, Willie JT, Sheth SA, Bijanki KR. Intracranial stimulation and EEG feature analysis reveal affective salience network specialization. Brain. 2023 Oct 3;146(10):4366-4377. doi: 10.1093/brain/awad200.
- Bijanki KR, Kovach CK, McCormick LM, Kawasaki H, Dlouhy BJ, Feinstein J, Jones RD, Howard MA 3rd. Case report: stimulation of the right amygdala induces transient changes in affective bias. Brain Stimul. 2014 Sep-Oct;7(5):690-3. doi: 10.1016/j.brs.2014.05.005. Epub 2014 May 24.
- Marneweck M, Loftus A, Hammond G. Psychophysical measures of sensitivity to facial expression of emotion. Front Psychol. 2013 Feb 20;4:63. doi: 10.3389/fpsyg.2013.00063. eCollection 2013.
- Hershey T, Campbell MC, Videen TO, Lugar HM, Weaver PM, Hartlein J, Karimi M, Tabbal SD, Perlmutter JS. Mapping Go-No-Go performance within the subthalamic nucleus region. Brain. 2010 Dec;133(Pt 12):3625-34. doi: 10.1093/brain/awq256. Epub 2010 Sep 20.
- McIntosh LG, Mannava S, Camalier CR, Folley BS, Albritton A, Konrad PE, Charles D, Park S, Neimat JS. Emotion recognition in early Parkinson's disease patients undergoing deep brain stimulation or dopaminergic therapy: a comparison to healthy participants. Front Aging Neurosci. 2015 Jan 21;6:349. doi: 10.3389/fnagi.2014.00349. eCollection 2014.
- Albuquerque L, Coelho M, Martins M, Guedes LC, Rosa MM, Ferreira JJ, Cattoni MB, Carvalho H, Ferreira AG, Martins IP. STN-DBS does not change emotion recognition in advanced Parkinson's disease. Parkinsonism Relat Disord. 2014 Feb;20(2):166-9. doi: 10.1016/j.parkreldis.2013.10.010. Epub 2013 Oct 18.
- Berney A, Panisset M, Sadikot AF, Ptito A, Dagher A, Fraraccio M, Savard G, Pell M, Benkelfat C. Mood stability during acute stimulator challenge in Parkinson's disease patients under long-term treatment with subthalamic deep brain stimulation. Mov Disord. 2007 Jun 15;22(8):1093-6. doi: 10.1002/mds.21245.
- Schneider F, Habel U, Volkmann J, Regel S, Kornischka J, Sturm V, Freund HJ. Deep brain stimulation of the subthalamic nucleus enhances emotional processing in Parkinson disease. Arch Gen Psychiatry. 2003 Mar;60(3):296-302. doi: 10.1001/archpsyc.60.3.296.
- Wagenbreth C, Wattenberg L, Heinze HJ, Zaehle T. Implicit and explicit processing of emotional facial expressions in Parkinson's disease. Behav Brain Res. 2016 Apr 15;303:182-90. doi: 10.1016/j.bbr.2016.01.059. Epub 2016 Feb 2.
- Mermillod M, Mondillon L, Rieu I, Devaux D, Chambres P, Auxiette C, Dalens H, Coulangeon LM, Jalenques I, Durif F. Dopamine replacement therapy and deep brain stimulation of the subthalamic nuclei induce modulation of emotional processes at different spatial frequencies in Parkinson's disease. J Parkinsons Dis. 2014;4(1):97-110. doi: 10.3233/JPD-130256.
- Mondillon L, Mermillod M, Musca SC, Rieu I, Vidal T, Chambres P, Auxiette C, Dalens H, Marie Coulangeon L, Jalenques I, Lemaire JJ, Ulla M, Derost P, Marques A, Durif F. The combined effect of subthalamic nuclei deep brain stimulation and L-dopa increases emotion recognition in Parkinson's disease. Neuropsychologia. 2012 Oct;50(12):2869-2879. doi: 10.1016/j.neuropsychologia.2012.08.016. Epub 2012 Aug 28.
- Peron J, Biseul I, Leray E, Vicente S, Le Jeune F, Drapier S, Drapier D, Sauleau P, Haegelen C, Verin M. Subthalamic nucleus stimulation affects fear and sadness recognition in Parkinson's disease. Neuropsychology. 2010 Jan;24(1):1-8. doi: 10.1037/a0017433.
- Drapier D, Peron J, Leray E, Sauleau P, Biseul I, Drapier S, Le Jeune F, Travers D, Bourguignon A, Haegelen C, Millet B, Verin M. Emotion recognition impairment and apathy after subthalamic nucleus stimulation in Parkinson's disease have separate neural substrates. Neuropsychologia. 2008 Sep;46(11):2796-801. doi: 10.1016/j.neuropsychologia.2008.05.006. Epub 2008 May 20.
- Biseul I, Sauleau P, Haegelen C, Trebon P, Drapier D, Raoul S, Drapier S, Lallement F, Rivier I, Lajat Y, Verin M. Fear recognition is impaired by subthalamic nucleus stimulation in Parkinson's disease. Neuropsychologia. 2005;43(7):1054-9. doi: 10.1016/j.neuropsychologia.2004.10.006. Epub 2004 Dec 30.
- Dujardin K, Blairy S, Defebvre L, Krystkowiak P, Hess U, Blond S, Destee A. Subthalamic nucleus stimulation induces deficits in decoding emotional facial expressions in Parkinson's disease. J Neurol Neurosurg Psychiatry. 2004 Feb;75(2):202-8.
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