Introduction: The subthalamic nucleus (STN) is thought to be preferentially engaged during high-conflict decision making in humans. The population neuronal spike rate in the STN has been reported to increase during decision conflict. Conflict and feedback-related activity is also reflected in theta-band (4-8 Hz) oscillations in the STN. It remains unknown how single-neuron activity and theta-band local field potentials (LFP) oscillations interact to support decision making.
Methods: We simultaneously recorded single-neuron spike activity and LFP from the STN of eight Parkinson's disease (PD) patients while they performed a novel Aversion-Reward conflict (ARC) task. Subjects decide whether to accept an offer of a monetary reward paired with a variable risk of an aversive air puff to the eye. By varying the reward and risk, we are able to study approach-avoidance decision making across a range of conflict. Using this task, we examined the mechanism of how theta-frequency oscillation and entrained single neurons involve humans’ integration of cost and benefit and decision at various conflict statuses.
Results: The ARC task reveals diverse risk-reward tradeoff strategies of patients. Consistent across patients, there is a positive correlation between the degree of decision conflict and reaction time (e.g., higher conflict offers require longer for subjects to decide). During high-conflict decisions, LFP in STN had increased activity of sub-theta oscillation, while increased activity of theta was found during low-conflict decisions. Single-trial STN theta-band power was correlated with degree of decision conflict. Interestingly, the decision to take or forgo the reward is predicted by theta-frequency phase-locked of STN neurons.
Conclusions: Our findings support the hypothesis that theta-band oscillations in single-neurons reflect the engagement of STN during conflict decision making. Furthermore, STN neurons with theta-band entrainment correlate with willingness to approach risk to pursue reward.
Patient Care: Subthalamic nucleus deep brain stimulation might influence limbic circuit coherence and lead to variable psychiatric symptoms.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of coordination between neuronal firing and LFP of STN regarding approach-avoidance decision process, 2) Discuss the engagement of STN during conflict