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Dissociable Effects of Subthalamic Stimulation in Obsessive Compulsive Disorder on Risky Reward and Loss Prospects.

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Droux, Fabien 
Chabardes, Stephan 
Bougerol, Thierry 
Kohl, Sina 


Our daily decisions involve an element of risk, a behavioral process that is potentially modifiable. Here we assess the role of the associative-limbic subthalamic nucleus (STN) in obsessive compulsive disorder (OCD) testing on and off deep-brain stimulation (DBS) on anticipatory risk taking to obtain rewards and avoid losses. We assessed 12 OCD STN DBS in a randomized double-blind within-subject cross-over design. STN DBS decreased risk taking to rewards (p = 0.02) and greater risk taking to rewards was positively correlated with OCD severity (p = 0.01) and disease duration (p = 0.01). STN DBS was also associated with impaired subjective discrimination of loss magnitude (p < 0.05), an effect mediated by acute DBS rather than chronic DBS. We highlight a role for the STN in mediating dissociable valence prospects on risk seeking. STN stimulation decreases risk taking to rewards and impairs discrimination of loss magnitude. These findings may have implications for behavioral symptoms related to STN DBS and the potential for STN DBS for the treatment of psychiatric disorders.



deep-brain stimulation, obsessive–compulsive disorder, reward, risk taking, subthalamic nucleus, Adult, Cross-Over Studies, Deep Brain Stimulation, Double-Blind Method, Female, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Reward, Risk-Taking, Subthalamic Nucleus

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Elsevier BV
Wellcome Trust (093705/Z/10/Z)
National Institute for Health Research (NIHR) (via Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) (CLRN 12-13)
National Institute for Health Research (NIHR) (via Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) (unknown)
Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) (2014/15)
Medical Research Council (MR/P008747/1)