Neuroimaging and cognitive changes during déjà vu.
OBJECTIVE
The cause or the physiological role of déjà vu (DV) in healthy people is unknown. The pathophysiology of DV-type epileptic aura is also unresolved. Here we describe a 22-year-old woman treated with deep brain stimulation (DBS) of the left internal globus pallidus for hemidystonia. At certain stimulation settings, DBS elicited reproducible episodes of DV.


METHODS
Neuropsychological tests and single-photon-emission computed tomography (SPECT) were performed during DBS-evoked DV and during normal DBS stimulation without DV.


RESULTS
SPECT during DBS-evoked DV revealed hyperperfusion of the right (contralateral to the electrode) hippocampus and other limbic structures. Neuropsychological examinations performed during several evoked DV episodes revealed disturbances in nonverbal memory.


CONCLUSIONS
Our results confirm the role of mesiotemporal structures in the pathogenesis of DV. We hypothesize that individual neuroanatomy and disturbances in gamma oscillations or in the dopaminergic system played a role in DBS-elicited DV in our patient.
Kovacs
Norbert
N
Department of Neurology, University of Pecs, Pecs, Hungary. kovacsnorbert06@gmail.com
Auer
Tibor
T
Balas
Istvan
I
Karadi
Kazmer
K
Zambo
Katalin
K
Schwarcz
Attila
A
Klivenyi
Peter
P
Jokeit
Hennric
H
Horvath
Krisztina
K
Nagy
Ferenc
F
Janszky
Jozsef
J
D003071:Cognition / Q000502:physiology*; D046690:Deep Brain Stimulation; D003690:Deja Vu / Q000523:psychology*; D004827:Epilepsy / Q000000981:diagnostic imaging* / Q000473:pathology / Q000523:psychology; D005260:Female; D005917:Globus Pallidus / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009483:Neuropsychological Tests; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult
D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime