UC San Francisco

“Decoding motivation in Parkinson's Disease with sensing enabled neurostimulation”

Stephanie’s research investigates the brain signals underlying mood and motivated decision-making in people with Parkinson’s Disease. Using specialized brain stimulation implants that can also record neural activity, she has identified a brain rhythm encoding decision expectations and mood that stimulation measurably disrupts. She aims to use this brain signal to develop adaptive, closed-loop therapies that treat apathy and impulsivity with greater precision and personalization.”

ABSTRACT

Parkinson's Disease (PD) affects not only movement but also motivation and emotional wellbeing — symptoms that are severely underdiagnosed and undertreated. Apathy, the pathological loss of motivation, affects over 35% of PD patients and has no current cure, yet can be as debilitating as the physical symptoms. Deep brain stimulation (DBS) is a well-established therapy for Parkinsonian tremor, but its effects on mood and
motivation are poorly understood. This research addresses that gap using DBS devices that can simultaneously stimulate and record brain activity while patients complete reward-based decision-making tasks. The findings reveal that a specific brain rhythm uniquely tracks how happy someone feels after a decision outcome, and that DBS disrupts this rhythm. DBS also affects how the brain tracks the value of an upcoming decision, offering a potential window into why stimulation can alter healthy decision-making and the integration of reward information. Together, these results point toward using these rhythms as biomarkers to develop adaptive DBS therapies that are more targeted and personalized.