Functional topography of the ventral striatum and anterior limb of the internal capsule determined by electrical stimulation of awake patients.
OBJECTIVE
To assess the behavioral and subjective effects of acute electrical stimulation along the anterior limb of the internal capsule (ALIC) and ventral striatum (VS).


METHODS
Intraoperative awake electrical stimulation and postoperative programming was performed in a group of 6 patients with major depressive disorder (MDD) undergoing bilateral deep brain stimulation of the ALIC and VS areas.


RESULTS
Electrical stimulation of the VS area acutely produced changes in mood as well as alertness, anxiety, dizziness, sensation of warmth and "flushing". Stimulation of the ventral capsule area just dorsal to the anterior commissure was associated with increments in mood, sensation of energy and alertness, laughing, calmness and talkative behavior. Behavioral effects were less commonly observed with stimulation of the dorsal region of the ALIC.


CONCLUSIONS
Acute behavioral and subjective responses can be consistently obtained from stimulation in the ventral ALIC and VS region. Positive changes in mood and anxiety were reproducibly elicited in the ventral ALIC area.


CONCLUSIONS
Intraoperative awake stimulation and postoperative programming of patients undergoing DBS for MDD provide unique opportunities to explore the subjective responses and behavioral phenomena related to electrical stimulation of the area spanning from the dorsal ALIC to the ventral striatum.
Center for Neurological Restoration, Department of Neurosurgery, Cleveland Clinic, 9500 Euclid Ave., Desk S31, Cleveland, OH 44195, USA. Electronic address: machada@ccf.org.
Andre
A
Machado
Department of Pharmacology and Physiology, University of Rochester, Medical Center, USA.
Suzanne
S
Haber
Department of Psychiatry and Human Behavior, Brown University, USA.
Nathaniel
N
Sears
Brown University, USA.
Benjamin
B
Greenberg
Psychiatry Neuromodulation Center, Cleveland Clinic, USA.
Donald
D
Malone
Department of Neurosurgery, Ohio State University, USA.
Ali
A
Rezai
D001479:Basal Ganglia / Q000502:physiology*; D001931:Brain Mapping / Q000379:methods*; D046690:Deep Brain Stimulation / Q000379:methods*; D003865:Major Depressive Disorder / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D020772:Internal Capsule / Q000502:physiology*; D014851:Wakefulness / Q000502:physiology*