deep brain stimulation of nucleus accumbens region in alcoholism affects reward processing脑深部电刺激伏隔核区域的酗酒影响奖励处理.pdf

Deep Brain Stimulation of Nucleus Accumbens Region in Alcoholism Affects Reward Processing 1,2 3 ¨ 4 5 1 ¨ 5 Marcus Heldmann *, Georg Berding , Jurgen Voges , Bernhard Bogerts , Imke Galazky , Ulf Muller , 3 1 ¨ 2 Gunther Baillot , Hans-Jochen Heinze , Thomas F. Munte ¨ ¨ 1 Department of Neurology, University of Magdeburg, Magdeburg, Germany, 2 Department of Neurology, University of Lubeck, Lubeck, Germany, 3 Department of Nuclear Medicine, Medical School Hannover, Hannover, Germany, 4 Department of Stereotactic Neurosurgery, University of Magdeburg, Magdeburg, Germany, 5 Department of Psychiatry, University of Magdeburg, Magdeburg, Germany Abstract The influence of bilateral deep brain stimulation (DBS) of the nucleus nucleus (NAcc) on the processing of reward in a gambling paradigm was investigated using H2[15O]-PET (positron emission tomography) in a 38-year-old man treated for severe alcohol addiction. Behavioral data analysis revealed a less risky, more careful choice behavior under active DBS compared to DBS switched off. PET showed win- and loss-related activations in the paracingulate cortex, temporal poles, precuneus and hippocampus under active DBS, brain areas that have been implicated in action monitoring and behavioral control. Except for the temporal pole these activations were not seen when DBS was deactivated. These findings suggest that DBS of the NAcc may act partially by improving behavioral control. Citation: Heldmann M, Berding G, Voges J, Bog