Optimal decision-making requires balancing fast but error-prone and more accurate but slower decisions through adjustments of decision thresholds. Here, we demonstrate two distinct correlates of such speed-accuracy adjustments by recording subthalamic nucleus (STN) activity and electroencephalography in 11 Parkinson’s disease patients during a perceptual decision-making task; STN low-frequency oscillatory (LFO) activity (2–8 Hz), coupled to activity at prefrontal electrode Fz, and STN beta activity (13–30 Hz) coupled to electrodes C3/C4 close to motor cortex. These two correlates differed not only in their cortical topography and spectral characteristics but also in the relative timing of recruitment and in their precise relationship with decision thresholds. Increases of STN LFO power preceding the response predicted increased thresholds only after accuracy instructions, while cue-induced reductions of STN beta power decreased thresholds irrespective of instructions. These findings indicate that distinct neural mechanisms determine whether a decision will be made in haste or with caution. In everyday decisions, we have to balance how quickly we need to make a decision with how accurate we want our decision to be. For example, if you plan your next holiday you might want to make sure that you pick the best destination without caring too much about the time it takes to arrive at that decision. On the other hand, in your lunch break you might want to quickly choose between the different meals on the menu to make sure you are back at work on time, even though you might overlook a dish that you would have preferred. This effect – that decisions we make in haste are more likely to be suboptimal than slower, more deliberate decisions – is known as the speed-accuracy trade-off. One theory suggests that the activity of a brain area termed the subthalamic nucleus reflects whether people will prioritize speed or accuracy during decision-making. This area is seated deep inside the brain, meaning that it is normally difficult to record its activity. Herz et al. have now recorded the activity of the subthalamic nucleus in individuals with Parkinson’s disease who underwent brain surgery as part of their treatment. When these individuals switched between fast and cautious decision-making, the activity in the subthalamic nucleus changed, as did its relationship with the activity seen in other brain areas. Furthermore, these activity changes predicted how much information participants acquired before committing to a choice. Deep brain stimulation of the subthalamic nucleus is now a standard treatment for Parkinson’s disease. It will be important to assess whether this treatment affects the changes in subthalamic activity that are related to decision-making, and whether this affects whether an individual is more likely to make fast or accurate decisions.
