title: Pharmacological treatment of deep brain stimulation-induced hypomania leads to clinical remission while preserving motor benefits.
abstract: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for Parkinson's disease, but can lead to adverse effects including psychiatric disturbance. Little is known about the risk factors and treatment options for such effects. Here, we describe a patient who reproducibly developed stimulation-induced hypomania when using ventrally located electrodes and responded well to pharmacological intervention while leaving the stimulation parameters unchanged to preserve motor benefits. In spite of clinical remission, [¹⁵O]-positron-emission-tomography (PET) demonstrated activation patterns similar to those reported during mania. This case, therefore, highlights an important treatment option of adverse effects of DBS, but also points toward the need for investigations of its risk factors and their underlying neurobiological mechanisms.
authors.affiliation: Department of Psychiatry, University of Cologne, Cologne, Germany. leonhard.schilbach@uk-koeln.de
authors.forename: L
authors.initials: L
authors.lastname: Schilbach
authors.forename: P H
authors.initials: PH
authors.lastname: Weiss
authors.forename: J
authors.initials: J
authors.lastname: Kuhn
authors.forename: L
authors.initials: L
authors.lastname: Timmermann
authors.forename: J
authors.initials: J
authors.lastname: Klosterkötter
authors.forename: W
authors.initials: W
authors.lastname: Huff
mesh_terms: D018692:Antimanic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000209:etiology*; D003024:Clozapine / Q000627:therapeutic use*; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000628:therapy; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D018692:Antimanic Agents; D014635:Valproic Acid; D003024:Clozapine