Manic behaviour induced by deep-brain stimulation in Parkinson's disease: evidence of substantia nigra implication?
We report the case of a patient who had benefited from bilateral subthalamic nucleus deep brain stimulation for Parkinson's disease and who presented acute and reproducible manic behaviour when stimulated mainly in the substantia nigra. A positron emission tomography scan showed an activation of the right dorsolateral prefrontal and inferior temporal cortex, the left anterior cingulate cortex and a deactivation of the left insula. This suggests that changes in cortical activation related to mania are subcortically driven, involving notably the substantia nigra.
Ulla
M
M
Univ Clermont 1, UFR Médecine, Clermont-Ferrand, France. mulla@chu-clermontferrand.fr
Thobois
S
S
Lemaire
J-J
JJ
Schmitt
A
A
Derost
P
P
Broussolle
E
E
Llorca
P-M
PM
Durif
F
F
D001714:Bipolar Disorder / Q000209:etiology*; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010300:Parkinson Disease / Q000628:therapy*; D013378:Substantia Nigra / Q000502:physiology*; D020531:Subthalamic Nucleus / Q000502:physiology