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Neuropsychol Rev. 2015 Dec;25(4):398-410. doi: 10.1007/s11065-015-9306-9. Epub 2015 Nov 14.

The Subthalamic Nucleus, Limbic Function, and Impulse Control.

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Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA.
Department of Neurology, University of Florida College of Medicine, HSC Box 100236, Gainesville, FL, 32610-0236, USA.
J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA.


It has been well documented that deep brain stimulation (DBS) of the subthalamic nucleus (STN) to address some of the disabling motor symptoms of Parkinson's disease (PD) can evoke unintended effects, especially on non-motor behavior. This observation has catalyzed more than a decade of research concentrated on establishing trends and identifying potential mechanisms for these non-motor effects. While many issues remain unresolved, the collective result of many research studies and clinical observations has been a general recognition of the role of the STN in mediating limbic function. In particular, the STN has been implicated in impulse control and the related construct of valence processing. A better understanding of STN involvement in these phenomena could have important implications for treating impulse control disorders (ICDs). ICDs affect up to 40% of PD patients on dopamine agonist therapy and approximately 15% of PD patients overall. ICDs have been reported to be associated with STN DBS. In this paper we will focus on impulse control and review pre-clinical, clinical, behavioral, imaging, and electrophysiological studies pertaining to the limbic function of the STN.


Deep brain stimulation; Impulse control disorder; Subthalamic nucleus

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