title: Underlying neurobiology and clinical correlates of mania status after subthalamic nucleus deep brain stimulation in Parkinson's disease: a review of the literature.
abstract: Deep brain stimulation (DBS) is a novel and effective surgical intervention for refractory Parkinson's disease (PD). The authors review the current literature to identify the clinical correlates associated with subthalamic nucleus (STN) DBS-induced hypomania/mania in PD patients. Ventromedial electrode placement has been most consistently implicated in the induction of STN DBS-induced mania. There is some evidence of symptom amelioration when electrode placement is switched to a more dorsolateral contact. Additional clinical correlates may include unipolar stimulation, higher voltage (&gt;3 V), male sex, and/or early-onset PD. STN DBS-induced psychiatric adverse events emphasize the need for comprehensive psychiatric presurgical evaluation and follow-up in PD patients. Animal studies and prospective clinical research, combined with advanced neuroimaging techniques, are needed to identify clinical correlates and underlying neurobiological mechanisms of STN DBS-induced mania. Such working models would serve to further our understanding of the neurobiological underpinnings of mania and contribute valuable new insight toward development of future DBS mood-stabilization therapies.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester MN, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Chopra
authors.forename: Susannah J
authors.initials: SJ
authors.lastname: Tye
authors.forename: Kendall H
authors.initials: KH
authors.lastname: Lee
authors.forename: Shirlene
authors.initials: S
authors.lastname: Sampson
authors.forename: Joseph
authors.initials: J
authors.lastname: Matsumoto
authors.forename: Andrea
authors.initials: A
authors.lastname: Adams
authors.forename: Bryan
authors.initials: B
authors.lastname: Klassen
authors.forename: Matt
authors.initials: M
authors.lastname: Stead
authors.forename: Julie A
authors.initials: JA
authors.lastname: Fields
authors.forename: Mark A
authors.initials: MA
authors.lastname: Frye
mesh_terms: D001714:Bipolar Disorder / Q000209:etiology*; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D006801:Humans; D016239:MEDLINE / Q000706:statistics & numerical data; D010300:Parkinson Disease / Q000628:therapy*; D020531:Subthalamic Nucleus / Q000502:physiology*