{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:52:36Z","timestamp":1786978356352,"version":"build-2736575974"},"reference-count":80,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100022222","name":"Parkinson Schweiz","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100022222","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Impulse 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\u2010DBS), others report worsening of ICD or impulsivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim was to study ICD in the context of STN\u2010DBS using an objective measure of decision\u2010making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Ten PD patients performed an effort\u2010based decision\u2010making task alongside neuropsychiatric and cognitive evaluation before and 4\u2009months after STN\u2010DBS. Further, 33 PD patients underwent the same experimental procedures just once after an average 40\u2009months of chronic STN\u2010DBS. Participants were examined preoperatively in the medication\n                      <jats:italic>on<\/jats:italic>\n                      state and postoperatively in the medication\n                      <jats:italic>on<\/jats:italic>\n                      \/stimulation ON state. Mixed linear models were used to assess the impact of ICD and STN\u2010DBS on acceptance rate and decision time in the task while controlling for motor symptom burden, cognitive measures, and dopaminergic medication.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Results 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\u2010DBS. Further, ICD, cognitive processing speed, and STN\u2010DBS were all identified as positive predictors for faster decision speed. ICD scores showed a tendency to improve 4\u2009months after STN\u2010DBS, without an increase in apathy scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Chronic STN\u2010DBS and ICD facilitate effort\u2010based decision\u2010making by speeding up judgment. Furthermore, ICD enhances the willingness to exert high levels of effort for reward. Both STN\u2010DBS and dopaminergic medication impact motivated behavior and should be titrated carefully to balance neuropsychiatric symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.14318","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T04:21:27Z","timestamp":1735878087000},"page":"484-496","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Impulse Control Disorders and Effort\u2010Based Decision\u2010Making in Parkinson's Disease Patients with Subthalamic Nucleus Deep Brain Stimulation"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2268-8021","authenticated-orcid":false,"given":"Deborah","family":"Amstutz","sequence":"first","affiliation":[{"name":"Department of Neurology Inselspital, University Hospital Bern, University of Bern  Bern Switzerland"},{"name":"Graduate School for Health Sciences, University of Bern  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