Brain activation associated with deep brain stimulation causing dissociation in a patient with Tourette's syndrome.
Dissociation involves a disruption in the integrated functions of consciousness, memory, identity, or perception of the environment. Attempts at localizing dissociative responses have yielded contradictory results regarding brain activation, laterality, and regional involvement. Here, we used a single-day split-dose activation paradigm with single photon emission computed tomography and 99m-Tc ethylcysteinatedimer as a brain perfusion tracer in a patient with Tourette's syndrome undergoing bilateral high-frequency thalamic stimulation for the treatment of tics who developed an alternate personality state during right thalamic stimulation. We documented increased regional cerebral blood flow in bilateral prefrontal and left temporal brain areas during the alternate identity state. We conclude that our findings support the temporal lobe as well as the frontolimbic disconnection hypotheses of dissociation.
Goethals
Ingeborg
I
Department of Nuclear Medicine, Ghent University Hospital. ingeborg.goethals@ugent.be
Jacobs
Filip
F
Van der Linden
Chris
C
Caemaert
Jacques
J
Audenaert
Kurt
K
D000328:Adult; D001921:Brain / Q000378:metabolism*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000378:metabolism*; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D004213:Dissociative Disorders / Q000150:complications* / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires; D005879:Tourette Syndrome / Q000150:complications* / Q000628:therapy*