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Variability of Changes in Emotion Recognition with Deep Brain Stimulation depends on the Location of the Stimulation Volume in the Subthalamic Nucleus

Klimaschewski, C.; Bingoel, D.; Waldthaler, J.; Pedrosa, D.

2025-11-04 neurology
10.1101/2025.11.03.25339378 medRxiv
Show abstract

The impact of Deep Brain Stimulation (DBS) on emotion processing remains debated. The aim of this study was to investigate whether the localisation of stimulation within the subthalamic nucleus (STN) differentially influences emotion processing in sixteen patients with Parkinsons disease. An emotion recognition task was employed before and three months after STN-DBS surgery in off-medication state. Volumes of activated tissue (VATs) were mapped to STN subregions and correlated with task performance changes. Larger right ventrolateral non-motor STN VATs were associated with improved recognition of positive emotions ({rho} = 0.54, p = 0.04). This association was right-lateralised, involving fibres connecting the STN to the prefrontal cortex, suggesting a lateralised network basis for emotion processing in PD. Larger VATs in left dorsolateral STN were linked to perceiving emotions more positively. Our findings highlight the role of stimulation site in non-motor STN-DBS outcomes which may explain previous inconsistent findings regarding DBS-effects on emotion processing.

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