Jump to content
helplinedonate
  • Announcements

    • ForumAdmin

      Frequently Asked Questions - Step by step guides

      Do you need assistance registering, logging in, posting, etc? Please visit the all new Frequently Asked Question Forum for step-by-step guides. Click the link below to access these helpful guides. Frequently Asked Questions
    • ForumAdmin

      Recursos Nuevos en Español

      http://www.parkinson.org/ayuda   http://www.parkinson.org/espanol    
    • ForumAdmin

      Línea de Ayuda 1-800-473-4636

      Línea de Ayuda 1-800-473-4636   ¿Qué es la línea de ayuda 1-800-4PD-INFO (473-4636) de la Fundación Nacional de Parkinson? Es un número de teléfono gratuito que ayuda a las personas con la enfermedad de Parkinson, sus familiares, amigos y profesionales de salud, a solucionar diferentes inquietudes.   La línea de ayuda ofrece: Información actualizada Apoyo emocional Referidos a profesionales de salud Recursos comunitarios Amplia variedad de publicaciones gratis    
Sign in to follow this  
Dr. Okun

Post of the Wee: Mania and DBS may Depend on Where you Stimulate

Recommended Posts

Dr. Okun    409

Dear forum members,

 

One of the potential side effects of DBS therapy is inducing a very positive mood state referred to as mania. These authors examined where DBS leads were located in patients that got "manic" and the majority were stimulated off of deep contacts in the substantia nigra region. If this side effect is encountered you should seek medical attention immediately either for reprogramming or for changes in medicine (mood stabilizers). Here is the abstract below:

 

J Neurol Neurosurg Psychiatry. 2010 Nov 3. [Epub ahead of print]

Contact dependent reproducible hypomania induced by deep brain stimulation in Parkinson's disease: clinical, anatomical and functional imaging study.

Ulla M, Thobois S, Llorca PM, Derost P, Lemaire JJ, Chereau-Boudet I, de Chazeron I, Schmitt A, Ballanger B, Broussolle E, Durif F.

 

CHU Clermont-Ferrand, Service de Neurologie A, Clermont-Ferrand, France.

Abstract

Hypomanic symptoms depending on anatomical location of contacts are reported in patients with Parkinson's disease (PD) treated by deep brain stimulation (DBS) of the subthalamic nucleus (STN). However, the underlying cortical and subcortical dysfunction is debated. In this study, five PD patients implanted with DBS-STN who presented with reversible and reproducible hypomanic symptoms after stimulation of specific 'manic' contacts were investigated. Hypomanic symptoms were assessed using the Bech and Rafaelsen Mania Scale (MAS). Three dimensional anatomical location of 'euthymic' and 'manic' contacts, after matching the postoperative CT scan with the preoperative stereotactic MRI, and a H(2)(15)O positron emission tomography (PET) study testing 'euthymic' and 'manic' contacts, were performed. Under 'euthymic' conditions, MAS score (mean±SD) was 0.6±0.5 compared with 7.8±3.1 under 'manic' conditions. Nine of 10 'manic' contacts were located in the substantia nigra, mainly in its ventral part. PET showed that hypomania was associated with strong asymmetrical cerebral activation involving preferentially the right hemisphere and was mediated by activation of the anterior cingulate and medial prefrontal cortex. The present study demonstrates the role of the subcortical structures in the genesis of hypomania in PD patients treated with DBS and stresses the involvement of the substantia nigra.

 

PMID: 21047882 [PubMed - as supplied by publisher]

 

LinkOut - more resources

Edited by Dr. Okun

Share this post


Link to post
Share on other sites
Sign in to follow this  

×