title: Dopamine dysregulation syndrome after deep brain stimulation of the subthalamic nucleus in Parkinson's disease.
abstract: Dopamine dysregulation syndrome is a complication of the dopaminergic treatment for Parkinson's disease, probably related to sensitization of the mesolimbic dopamine system. The relationship between dopamine dysregulation syndrome and deep brain stimulation of the subthalamic nucleus remains unclear. We report three patients with Parkinson's disease who developed de novo dopamine dysregulation syndrome after deep brain stimulation of the subthalamic nucleus. We hypothesized that the combined effect of dopaminergic replacement therapy and deep brain stimulation on the limbic territory of the subthalamic nucleus could have precipitated the dopamine dysregulation syndrome in these patients, by inducing hyperstimulation of the mesolimbic dopamine system. The outcome of postoperative dopamine dysregulation syndrome is poor despite deep brain stimulation adjustments, attempts to reduce the dose of dopaminergic drugs and the addition of quetiapine or antidepressants.
authors.affiliation: Movement Disorders Research Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: De la Casa-Fages
authors.forename: Francisco
authors.initials: F
authors.lastname: Grandas
mesh_terms: D000978:Antiparkinson Agents / Q000009:adverse effects*; D003131:Combined Modality Therapy / Q000009:adverse effects; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D004298:Dopamine / Q000502:physiology; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D020531:Subthalamic Nucleus / Q000502:physiology*; D013577:Syndrome
chemical_list: D000978:Antiparkinson Agents; D004298:Dopamine