Investigating the impact of surgical masks on behavioral reactions to facial emotions in the COVID-19 era.

Introduction: The widespread use of surgical masks during the COVID-19 pandemic has posed challenges in interpreting facial emotions. As the mouth is known to play a crucial role in decoding emotional expressions, its covering is likely to affect this process. Recent evidence suggests that facial expressions impact behavioral responses only when their emotional content is relevant to subjects' goals. Thus, this study investigates whether and how masked emotional faces alter such a phenomenon. Methods: Forty participants completed two reaching versions of the Go/No-go task in a counterbalanced fashion. In the Emotional Discrimination Task (EDT), participants were required to respond to angry, fearful, or happy expressions by performing a reaching movement and withholding it when a neutral face was presented. In the Gender Discrimination Task (GDT), the same images were shown, but participants had to respond according to the poser's gender. The face stimuli were presented in two conditions: covered by a surgical mask (masked) or without any covering (unmasked). Results: Consistent with previous studies, valence influenced behavioral control in the EDT but not in the GDT. Nevertheless, responses to facial emotions in the EDT exhibited significant differences between unmasked and masked conditions. In the former, angry expressions led to a slowdown in participants' responses. Conversely, in the masked condition, behavioral reactions were impacted by fearful and, to a greater extent, by happy expressions. Responses to fearful faces were slower, and those to happy faces exhibited increased variability in the masked condition compared to the unmasked condition. Furthermore, response accuracy to masked happy faces dramatically declined compared to the unmasked condition and other masked emotions. Discussion: In sum, our findings indicate that surgical masks disrupt reactions to emotional expressions, leading people to react less accurately and with heightened variability to happy expressions, provided that the emotional dimension is relevant to people's goals.

Effects of dopaminergic treatment on inhibitory control differ across Hoehn and Yahr stages of Parkinson's disease.

Motor inhibitory control, a core component of cognitive control, is impaired in Parkinson's disease, dramatically impacting patients' abilities to implement goal-oriented adaptive strategies. A progressive loss of the midbrain's dopamine neurons characterizes Parkinson's disease and causes motor features responsive to dopaminergic treatments. Although such treatments restore motor symptoms, their impact on response inhibition is controversial. Most studies failed to show any effect of dopaminergic medicaments, although three studies found that these drugs selectively improved inhibitory control in early-stage patients. Importantly, all previous studies assessed only one domain of motor inhibition, i.e. reactive inhibition (the ability to react to a stop signal). The other domain, i.e. proactive inhibition (the ability to modulate reactive inhibition pre-emptively according to the current context), was utterly neglected. To re-examine this issue, we recruited cognitively unimpaired Parkinson's patients under dopaminergic treatment in the early (Hoehn and Yahr, 1-1.5, n = 20), intermediate (Hoehn and Yahr 2, n = 20), and moderate/advanced (Hoehn and Yahr, 2.5-3, n = 20) stages of the disease. Using a cross-sectional study design, we compared their performance on a simple reaction-time task and a stop-signal task randomly performed twice on dopaminergic medication (ON) and after medication withdrawal (OFF). Normative data were collected on 30 healthy controls. Results suggest that medication effects are stage-dependent. In Hoehn and Yahr 1-1.5 patients, drugs selectively impair reactive inhibition, leaving proactive inhibition unaffected. In the ON state, Hoehn and Yahr two patients experienced impaired proactive inhibition, whereas reactive inhibition is no longer affected, as it deteriorates even during the OFF state. By contrast, Hoehn and Yahr 2.5-3 patients exhibited less efficient reactive and proactive inhibition in the OFF state, and medication slightly improved proactive inhibition. This evidence aligns with the dopamine overdose hypothesis, indicating that drug administration may overdose intact dopamine circuitry in the earliest stages, impairing associated cognitive functions. In later stages, the progressive degeneration of dopaminergic neurons prevents the overdose and can exert some beneficial effects. Thus, our findings suggest that inhibitory control assessment might help tailor pharmacological therapy across the disease stage to enhance Parkinson's disease patients' quality of life by minimizing the hampering of inhibitory control and maximizing the reduction of motor symptoms.

Enhanced reactive inhibition in adolescents with non-suicidal self-injury disorder.

AIM: To investigate whether the core of the pathophysiology underlying non-suicidal self-injury (NSSI) relates to poor impulse control due to impaired motor inhibition (i.e. the ability to inhibit a preplanned motor response). METHOD: We conducted a case-control study to compare the proficiency of two domains of motor inhibition, that is, reactive and proactive inhibition, by giving the reaching arm version of the stop-signal task and a go-only task to 28 drug-naive adolescents with NSSI disorder (NSSID) (mean age [SD] 15 years 8 months [1 year 4 months]; three males and 25 females) and 28 typically developing adolescents (mean age 15 years 8 months [1 year 5 months]; three males and 25 females). RESULTS: Reactive inhibition, as determined by the duration of the stop-signal reaction time, was enhanced in adolescents with NSSID compared to typically developing controls (194.2 [22.5 ms] vs 217.5 [17.3 ms], p < 0.001). By contrast, proactive inhibition was similar in both groups. Lastly, the level of impulsivity, assessed using the Barratt Impulsiveness Scale Version 11, did not differ between typically developing adolescents and adolescents with NSSID. However, adolescents with NSSID were more impulsive than controls in a subscale of the UPPS-P Impulsive Behavior Scale. INTERPRETATION: NSSID is not driven by heightened motor impulsivity. Instead, adolescents with NSSID exhibited greater proficiency in reactive inhibition, a proxy for motor impulsivity. We suggest that the enhancement of reactive inhibition strengthens action control, allowing adolescents to suppress their self-protection instinct and perform NSSI behaviours.

Unveiling the influence of task-relevance of emotional faces on behavioral reactions in a multi-face context using a novel Flanker-Go/No-go task.

Recent research indicates that emotional faces affect motor control only when task-relevant. However, these studies utilized a single-face presentation, which does not accurately mirror real-life situations wherein we frequently engage with multiple individuals simultaneously. To overcome this limitation, we gave 40 participants two versions of a novel Flanker-Go/No-go task, where we presented three-face stimuli with a central target and two task-irrelevant flankers that could be congruent or incongruent with the target for valence and gender. In the Emotional Discrimination Task (EDT), participants had to respond to fearful or happy targets and refrain from moving with neutral ones. In the Gender Discrimination Task (GDT), the same images were shown, but participants had to respond according to the target's gender. In line with previous studies, we found an effect of valence only in EDT, where fearful targets increased reaction times and omission error rates compared to happy faces. Notably, the flanker effect, i.e., slower and less accurate responses in incongruent than congruent conditions, was not found. This likely stems from the higher perceptual complexity of faces than that of stimuli traditionally used in the Eriksen Flanker task (letters or signs), leading to a capacity limit in face feature processing.

Beyond Reactive Inhibition: Unpacking the Multifaceted Nature of Motor Inhibition.

Inhibition is a pillar of cognitive control, i [...].

Angry and happy expressions affect forward gait initiation only when task relevant.

Whole-body movements represent an ecologically valid model for assessing the effect of emotional stimuli valence on approach/avoidance reactions as they entail a change of the physical distance between such stimuli and the self. However, research in this field has provided inconsistent results as the task relevance of the emotional content of the stimuli was not properly controlled, and very often, it is impossible to dissociate the effect of arousal from that of valence. To overcome these limitations, we studied the effect of facial emotional expressions (anger and happiness) on forward gait initiation using an experimental paradigm that allows us to compare the impact of the stimuli emotional content when they are task relevant and when they are not. We found that angry and happy expressions altered forward gait initiation parameters differently only when relevant for ongoing goals. In particular, both the reaction times and the percentages of omission errors increased when the go signal was an angry face compared to when the go signal was a happy face. These results indicate that forward step movements share the same features as reaching arm movements regarding emotional stimuli, that is, facial emotions do not automatically influence behavioral responses. Instead, their effects depend critically on their conscious appraisal. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Emotional body postures affect inhibitory control only when task-relevant.

A classical theoretical frame to interpret motor reactions to emotional stimuli is that such stimuli, particularly those threat-related, are processed preferentially, i.e., they are capable of capturing and grabbing attention automatically. Research has recently challenged this view, showing that the task relevance of emotional stimuli is crucial to having a reliable behavioral effect. Such evidence indicated that emotional facial expressions do not automatically influence motor responses in healthy young adults, but they do so only when intrinsically pertinent to the ongoing subject's goals. Given the theoretical relevance of these findings, it is essential to assess their generalizability to different, socially relevant emotional stimuli such as emotional body postures. To address this issue, we compared the performance of 36 right-handed participants in two different versions of a Go/No-go task. In the Emotional Discrimination task, participants were required to withhold their responses at the display of emotional body postures (fearful or happy) and to move at the presentation of neutral postures. Differently, in the control task, the same images were shown, but participants had to respond according to the color of the actor/actress' t-shirt, disregarding the emotional content. Results showed that participants made more commission errors (instances in which they moved even though the No-go signal was presented) for happy than fearful body postures in the Emotional Discrimination task. However, this difference disappeared in the control task. Such evidence indicates that, like facial emotion, emotional body expressions do not influence motor control automatically, but only when they are task-relevant.

White matter alterations in drug-naïve children with Tourette syndrome and obsessive-compulsive disorder.

Tourette syndrome (TS) and early-onset obsessive-compulsive disorder (OCD) are frequently associated and conceptualized as distinct phenotypes of a common disease spectrum. However, the nature of their relationship is still largely unknown on a pathophysiological level. In this study, early structural white matter (WM) changes investigated through diffusion tensor imaging (DTI) were compared across four groups of drug-naïve children: TS-pure (n = 16), TS+OCD (n = 14), OCD (n = 10), and 11 age-matched controls. We analyzed five WM tracts of interest, i.e., cortico-spinal tract (CST), anterior thalamic radiations (ATR), inferior longitudinal fasciculus (ILF), corpus callosum (CC), and cingulum and evaluated correlations of DTI changes to symptom severity. Compared to controls, TS-pure and TS+OCD showed a comparable pattern of increased fractional anisotropy (FA) in CST, ATR, ILF and CC, with FA changes displaying negative correlation to tic severity. Conversely, in OCD, FA decreased in all WM tracts (except for the cingulum) compared to controls and negatively correlated to symptoms. We demonstrate different early WM microstructural alterations in children with TS-pure/TS+OCD as opposed to OCD. Our findings support the conceptualization of TS+OCD as a subtype of TS while suggesting that OCD is characterized by independent pathophysiological mechanisms affecting WM development.

The Cerebellum in Drug-naive Children with Tourette Syndrome and Obsessive-Compulsive Disorder.

Tourette syndrome (TS) and obsessive-compulsive disorder (OCD) are two neurodevelopmental disorders characterized by repetitive behaviors. Our recent study in drug-naive children with TS and OCD provided evidence of cerebellar involvement in both disorders. In addition, cerebellar functional connectivity (FC) was similar in TS patients without comorbidities (TSpure) and TS patients with OCD comorbidity (TS + OCD), but differed in pure OCD patients. To investigate in detail the cerebellar involvement in the pathophysiology of TS and OCD, we explored cerebellar structural and functional abnormalities in drug-naive children with TSpure, TS + OCD, and OCD and assessed possible correlations with severity scores. We examined 53 drug-naive children, classified as TSpure (n = 16), TS + OCD (n = 14), OCD (n = 11), or controls (n = 12). All subjects underwent a multimodal 3T magnetic resonance imaging examination. Cerebellar lobular volumes and quantitative diffusion tensor imaging parameters of cerebellar peduncles were used as measures of structural integrity. The dentate nucleus was selected as a region of interest to examine cerebello-cerebral functional connectivity alterations. Structural analysis revealed that both TSpure and TS + OCD patients had higher fractional anisotropy in cerebellar peduncles than controls. Conversely, OCD patients were characterized by lower fractional anisotropy than both controls and TSpure and TS + OCD patients. Lastly, cerebellar functional connectivity analysis revealed significant alterations in the cerebello-thalamo-cortical circuit in TSpure, TS + OCD, and OCD patients. Early cerebellar structural and functional changes in drug-naive pediatric TSpure, TS + OCD, and OCD patients support a primary role of the cerebellum in the pathophysiology of these disorders.

Happy facial expressions impair inhibitory control with respect to fearful facial expressions but only when task-relevant.

The ability to generate appropriate responses, especially in social contexts, requires integrating emotional information with ongoing cognitive processes. In particular, inhibitory control plays a crucial role in social interactions, preventing the execution of impulsive and inappropriate actions. In this study, we focused on the impact of facial emotional expressions on inhibition. Research in this field has provided highly mixed results. In our view, a crucial factor explaining such inconsistencies is the task-relevance of the emotional content of the stimuli. To clarify this issue, we gave two versions of a Go/No-go task to healthy participants. In the emotional version, participants had to withhold a reaching movement at the presentation of emotional facial expressions (fearful or happy) and move when neutral faces were shown. The same pictures were displayed in the other version, but participants had to act according to the actor's gender, ignoring the emotional valence of the faces. We found that happy expressions impaired inhibitory control with respect to fearful expressions, but only when they were relevant to the participants' goal. We interpret these results as suggesting that facial emotions do not influence behavioral responses automatically. They would instead do so only when they are intrinsically germane for ongoing goals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Inhibitory control and impulsive responses in neurodevelopmental disorders.

The impairment of inhibitory control is often assumed to be the core deficit of several neurodevelopmental disorders characterized by poor impulse control. However, could the same deficit explain different clinical phenotypes? Evidence from behavioural studies is very mixed. This is partly because inhibition is a highly complex executive function. Thus, the different types of tasks that generically tap into inhibitory control are likely to provide different outcomes. Additionally, sample inhomogeneity in terms of age, comorbidity, and medical treatment are confounding factors. Therefore, to make a reliable assessment of the deficit of inhibitory control in a given disorder, the same task and samples with similar characteristics must be employed. This article reviews and discusses studies on five neurodevelopmental disorders with impaired impulse control where these criteria have been used: Tourette syndrome; obsessive-compulsive disorder; attention-deficit/hyperactivity disorder; primary motor stereotypies; and autism spectrum disorder. Overall, they suggest that the mechanisms underlying the inability to control urges are extremely heterogeneous and cannot be ascribed to a general impairment of inhibition. These findings do not support the hypothesis that inhibitory deficits represent a transdiagnostic feature of neurodevelopmental disorders with poor impulse control. WHAT THIS PAPER ADDS: The mechanisms underlying the inability to control urges in neurodevelopmental disorders are heterogeneous. Inhibition impairments cannot generally explain all neurodevelopmental disorders characterized by poor urge control.

Threatening Facial Expressions Impact Goal-Directed Actions Only if Task-Relevant.

Facial emotional expressions are a salient source of information for nonverbal social interactions. However, their impact on action planning and execution is highly controversial. In this vein, the effect of the two threatening facial expressions, i.e., angry and fearful faces, is still unclear. Frequently, fear and anger are used interchangeably as negative emotions. However, they convey different social signals. Unlike fear, anger indicates a direct threat toward the observer. To provide new evidence on this issue, we exploited a novel design based on two versions of a Go/No-go task. In the emotional version, healthy participants had to perform the same movement for pictures of fearful, angry, or happy faces and withhold it when neutral expressions were presented. The same pictures were shown in the control version, but participants had to move or suppress the movement, according to the actor's gender. This experimental design allows us to test task relevance's impact on emotional stimuli without conflating movement planning with target detection and task switching. We found that the emotional content of faces interferes with actions only when task-relevant, i.e., the effect of emotions is context-dependent. We also showed that angry faces qualitatively had the same effect as fearful faces, i.e., both negative emotions decreased response readiness with respect to happy expressions. However, anger has a much greater impact than fear, as it increases both the rates of mistakes and the time of movement execution. We interpreted these results, suggesting that participants have to exploit more cognitive resources to appraise threatening than positive facial expressions, and angry than fearful faces before acting.

Resting-state functional connectivity in drug-naive pediatric patients with Tourette syndrome and obsessive-compulsive disorder.

Previous studies in cohorts of Tourette syndrome (TS) or obsessive-compulsive disorder (OCD) patients have not clarified whether these two disorders represent two clinical conditions or they are distinct clinical phenotypes of a common disease spectrum. The study aimed to compare functional connectivity (FC) patterns in a pediatric drug-naive cohort of 16 TS patients without any comorbidity (TS), 14 TS patients with OCD (TS + OCD), and 10 pure OCD patients as well as 11 matched controls that underwent resting state fMRI. Via independent component analysis, we examined FC in the basal ganglia (BGN), sensorimotor (SMN), cerebellum (CBN), frontoparietal (FPN), default-mode (DMN), orbitofrontal (OBFN), and salience (SAN) networks among the above cohorts and their association with clinical measures. Compared to controls, TS and TS + OCD patients showed higher FC in the BGN, SMN, CBN and DMN and lower FC in the FPN and SAN. The TS and TS + OCD groups showed comparable FC in all networks. In contrast to controls, OCD patients exhibited increased FC in the BGN, SMN, CBN, DMN, FPN, and SAN. OCD patients also showed higher FC in CBN and FPN when compared with TS and TS + OCD patients both separately and as one group. Tic severity negatively correlated with FC in CBN and FPN in the TS group, while the compulsiveness scores positively correlated with the same two networks in OCD patients. Our findings suggest common FC changes in TS and TS + OCD patients. In contrast, OCD is characterized by a distinctive pattern of FC changes prominently involving the CBN and FPN.

Loss in grey matter in a small network of brain areas underpins poor reactive inhibition in Obsessive-Compulsive Disorder patients.

Reactive inhibition correlates with the severity of symptoms in paediatric patients with Obsessive-Compulsive Disorder (OCD) though not in those with Tourette syndrome (TS). Here we assessed whether structural alterations in both grey (GM) and white matter (WM) volumes correlate with a measure of reactive inhibition, i.e. the stop-signal reaction time (SSRT), and with clinical scale scores. Nine OCD and 11 TS uncomplicated drug-naïve paediatric patients and 12 age-matched controls underwent 3T magnetic resonance imaging scanning. Between-group differences in GM and WM volumes across the whole brain were assessed. Outside the scanner, patients performed a reaching version of the stop-signal task. Both behavioural inhibitory control and neuroimaging measures were normal in TS patients. By contrast, OCD patients exhibited a significant loss in GM volume in five areas. The GM volume of the left inferior frontal gyrus was inversely correlated with the length of the SSRT, the left mid-cingulate gyrus and the right middle frontal gyrus were inversely correlated with the severity of OCD symptoms, and the left insula and the right medial orbitofrontal gyrus were inversely correlated with both. These results indicate that cortical areas showing GM loss in OCD patients are also involved in the network subserving reactive inhibition.

Children with primary complex motor stereotypies show impaired reactive but not proactive inhibition.

Typically, the inability to control urges tends to be ascribed to a lack of inhibitory control. Primary complex motor stereotypes (p-CMS), occurring in children with an otherwise typical development, represent a remarkable example of involuntary, complex, repetitive and apparently purposeless movements. However, it has never been tested whether the core of the pathophysiology of p-CMS lies in a deficit of inhibitory control. To fill this gap, we assessed whether children with p-CMS exhibit an impairment of one or both types of inhibition, i.e., reactive inhibition (the ability of subjects to react to a stop-signal) and/or proactive inhibition (the ability of subjects to shape their response strategies according to the context in which subjects are embedded). We compared inhibitory control of 20 drug-naïve patients with p-CMS (mean age ±SD: 7.4 ± 1.1) with that of 20 age- and gender-matched typically developing children (7.5 ± 1.2) via a reaching version of the stop-signal task. We found that while reactive inhibition is significantly impaired, proactive control in children with p-CMS is similar to that of the control group. The deficit in reactive control might explain why patients are unable to inhibit involuntary movements when triggered by states of mind such as stress, fatigue, boredom or excitement. Nevertheless, the absence of a deficit in proactive control suggests that patients are aware of the environmental context and thus they quickly stop the stereotypic movements when their attention is diverted. All in all, our findings might explain two key features of the p-CMS phenotype.

Early-stage Parkinson's patients show selective impairment in reactive but not proactive inhibition.

BACKGROUND: It is well known that a deficit in inhibitory control is a hallmark of Parkinson's disease (PD). However, inhibition is not a unitary construct, and it is unclear whether patients in the early stage of the disease (Hoehn and Yahr stage 1) exhibit a deficit in outright stopping (reactive inhibition), a deficit in the ability to shape their response strategies according to the context (proactive inhibition), or both. OBJECTIVE: We assessed whether PD patients at Hoehn and Yahr stage 1 show a global or selective impairment in inhibitory control. As it has been suggested that inhibition relies upon a right-lateralized pathway, we tested whether left-dominant PD patients suffered from a more severe deficit in this executive function than right-dominant PD patients. METHODS: Via a reaching stop-signal task, we assessed both proactive and reactive inhibition in 17 left-dominant PD and 17 right-dominant PD patients and in 24 age-matched participants. RESULTS: We found that reactive inhibition was more impaired in PD patients than in healthy participants. However, proactive inhibition was not affected. Furthermore, we found no differences between left-dominant PD and right-dominant PD patients. CONCLUSIONS: For the first time, we found evidence for a deficit of reactive inhibition in the early-stage PD patients in the absence of evidence for deficits in proactive inhibition. These findings have clinical relevance as they provide critical insights on the time course of the disease. In addition, we confirmed, on a population of PD patients at Hoehn and Yahr stage 1, previous results showing that the onset of the disease does not affect inhibition. © 2019 International Parkinson and Movement Disorder Society.

The Weight of Emotions in Decision-Making: How Fearful and Happy Facial Stimuli Modulate Action Readiness of Goal-Directed Actions.

Modern theories of behavioral control converge with the idea that goal-directed/voluntary behaviors are intimately tied to the evaluation of resources. Of key relevance in the decision-making processes that underlie action selection are those stimuli that bear emotional content. However, even though it is acknowledged that emotional information affects behavioral control, the exact way in which emotions impact on action planning is largely unknown. To clarify this issue, I gave an emotional version of a go/no-go task to healthy participants, in which they had to perform the same arm reaching movement when pictures of fearful or happy faces were presented, and to withhold it when pictures of faces with neutral expressions were presented. This task allows for the investigation of the effects of emotional stimuli when they are task-relevant without conflating movement planning with target detection and task switching. It was found that both the reaction times (RTs) and the percentages of errors increased when the go-signal was the image of a fearful looking face, as opposed to when the go-signal was a happy looking face. Importantly, to control for the role of the features of the stimuli, I ran a control task in which the same pictures were shown; however, participants had to move/withhold the commanded movement according to gender, disregarding the emotional valence. In this context, the differences between RTs and error percentages between the fearful and happy faces disappeared. On the one hand, these results suggest that fearful facial stimuli are likely to capture and hold attention more strongly than faces that express happiness, which could serve to increase vigilance for detecting a potential threat in an observer's environment. On the other hand, they also suggest that the influence of fearful facial stimuli is not automatic, but it depends on the task requirements.

Inhibition is impaired in children with obsessive-compulsive symptoms but not in those with tics.

BACKGROUND: Impaired inhibitory control is thought to be a core deficit in psychiatric disorders where patients exhibit problems with controlling urges. These problems include the urge to perform movements typical of Tourette syndrome and the urge to execute compulsive actions typical of obsessive-compulsive disorder. However, the picture emerging from studies that address this issue is controversial. Furthermore, most studies have only focused on reactive control (the ability of subjects to react to a stop signal), but not on proactive control (the ability of patients to shape their response strategies in anticipation of known task demands). OBJECTIVES: We assessed reactive and proactive inhibitory control in drug naïve children/adolescents affected by Tourette syndrome, obsessive-compulsive disorder, and in those in which the 2 disorders co-occur. METHODS: Reaching version of the stop signal task and of a simple reaction time task were given to 37 unmedicated patients (mean age ± SD, 11.0 ± 2.3) and to 37 healthy age- and gender-matched controls (mean age ± SD, 10.8 ± 1.6). RESULTS: Both reactive and proactive inhibition scaled with the severity of obsessive-compulsive symptoms, but not with those of tic symptoms (ie, inhibitory control in uncomplicated Tourette patients was comparable with that of healthy controls). CONCLUSIONS: We suggest that the cognitive mechanisms underlying tics and compulsions controls are likely to be different. Possibly the preserved ability to suppress actions in uncomplicated Tourette patients allows them to experience a greater feeling of self-control, and this fact might play a key role in evolution of the disorder beyond adolescence. © 2018 International Parkinson and Movement Disorder Society.

Unilateral Stimulation of Subthalamic Nucleus Does Not Affect Inhibitory Control.

Despite the relevance of inhibitory control in shaping our behavior its neural substrates are still hotly debated. In this regard, it has been suggested that inhibitory control relies upon a right-lateralized network which involves the right subthalamic nucleus (STN). To assess the role of STN, we took advantage of a relatively rare model, i.e., advanced Parkinson's patients who received unilateral deep-brain stimulation (DBS) of the STN either of the left (n = 10) or of the right (n = 10) hemisphere. We gave them a stop-signal reaching task, and we compared patients' performance in two experimental conditions, DBS-ON and DBS-OFF. In addition, we also tested 22 age-matched healthy participants. As expected, we found that inhibitory control is impaired in Parkinson's patients with respect to healthy participants. However, neither reactive nor proactive inhibition is improved when either the right or the left DBS is active. We interpreted these findings in light of the fact that previous studies, exploiting exactly the same task, have shown that only bilateral STN DBS restores a near-normal inhibitory control. Thus, although null results have to be interpreted with caution, our current findings confirm that the right STN does not play a key role in suppressing pending actions. However, on the ground of previous studies, it is very likely that this subcortical structure is part of the brain network subserving inhibition but to implement this executive function both subthalamic nuclei must be simultaneously active. Our findings are of significance to other researchers studying the effects of STN DBS on key executive functions, such as impulsivity and inhibition and they are also of clinical relevance for determining the therapeutic benefits of STN DBS as they suggest that, at least as far as inhibitory control is concerned, it is better to implant DBS bilaterally than unilaterally.