Subthalamic nucleus dynamics during executive functioning: Insights from local field potentials in Parkinson's disease.

This study explores the involvement of the subthalamic nucleus (STN) in executive functions, particularly cognitive flexibility, in Parkinson's disease (PD) patients. Utilizing a computerized Wisconsin Card Sorting Task (WCST) and local field potential (LFP) recordings from implanted deep brain stimulation (DBS) electrodes, we investigated task-specific neural dynamics. Behavioural results demonstrated increased error rates and prolonged response times in trials requiring set-shifting and rule induction via cross-temporal information integration. Electrophysiological analyses revealed integration-specific LFP modulations, including enhanced theta-band activity linked to conflict monitoring and cognitive control during high-demand trials, and beta-band suppression associated with motor inhibition and task disengagement. These findings underscore the STN's integrative role in non-motor domains, supporting its function in cross-temporal information integration for cognitive control. The results also highlight the utility of the WCST for assessing multiple executive processes and the potential of LFP-based biomarkers to refine DBS programming. Despite the relatively small sample size, this study provides novel insights into the oscillatory dynamics of the STN, emphasizing its broader role in decision-making and executive control. Future research should expand the understanding of the STN's contributions across cognitive domains.