Deep Brain Stimulation of Nucleus Accumbens Region in Alcoholism Affects Reward Processing

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

Behavioral data.

<p>Upper panel: Reaction times for the “5” and “25”-selections for each condition. Lower panel: percent choices for the “25”-selection for each condition.</p

Comparisons win>loss and loss>win with active and inactive DBS.

<p>Contrast images for the comparisons win>loss (color scale red/yellow) and loss>win (color scale blue/green) with active (left panel) and inactive (right panel) DBS in the target area. First level statistical analysis was performed with p<0.005 (uncorrected) and 50 voxel cluster threshold. Except for activation at the temporal pole no activation shown for the DBS on condition remained statistically significant when DBS was off.</p

Significant activations resulting from the comparison DBS on > DBS off (FWE 0.05, cluster-threshold 50 voxel).

<p>Significant activations resulting from the comparison DBS on > DBS off (FWE 0.05, cluster-threshold 50 voxel).</p

Significant activations related to the comparisons win vs. loss condition with DBS on (win on>loss on, loss on>win on) and win vs. loss condition with DBS off (win off>loss off, loss off>win off).

<p>Significant activations related to the comparisons win vs. loss condition with DBS on (win on>loss on, loss on>win on) and win vs. loss condition with DBS off (win off>loss off, loss off>win off).</p

Contrast image for the comparison DBS on>DBS off.

<p>Crosshair position indicates the location of the nucleus accumbens according to MNI standard coordinates. Activations are corrected for multiple comparisons (FWE = 0.05; cluster threshold 50 voxel). See <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0036572#pone-0036572-t001" target="_blank">table 1</a> for the corresponding list of activations.</p