title: Yawning induced by focal electrical stimulation in the human brain.
abstract: The primary function of yawning is not fully understood. We report a case in which electrical stimulation of the putamen in the human brain consistently elicited yawning. A 46-year-old woman with intractable epilepsy had invasive depth electrode monitoring and cortical stimulation mapping as part of her presurgical epilepsy evaluation. The first two contacts of a depth electrode that was intended to sample the left insula were in contact with the putamen. Stimulation of these contacts at 6mA and 8mA consistently elicited yawning on two separate days. Engagement in arithmetic and motor tasks during stimulation did not result in yawning. When considering the role of the putamen in motor control and its extensive connectivity to cortical and brainstem regions, our findings suggest that it plays a key role in the execution of motor movements necessitated by yawning. Furthermore, given the role of the anterior insula in attention and focused tasks, activation of this area while engaged in arithmetic and motor tasks could inhibit the putaminal processing necessary for yawning. Many have hypothesized the function of yawning; however, it remains debatable whether yawning serves a primarily physiological or communicative function or perhaps both.
authors.affiliation: Department of Neurology, George Washington University, 2150 Pennsylvania Avenue, 9th Floor, Washington, D.C. 20037, USA.
authors.forename: Sweta
authors.initials: S
authors.lastname: Joshi
authors.affiliation: Department of Neurology, George Washington University, 2150 Pennsylvania Avenue, 9th Floor, Washington, D.C. 20037, USA.
authors.forename: Arezou
authors.initials: A
authors.lastname: Bayat
authors.affiliation: Department of Neurology, George Washington University, 2150 Pennsylvania Avenue, 9th Floor, Washington, D.C. 20037, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Gagnon
authors.affiliation: Department of Neurological Surgery, George Washington University, 2150 Pennsylvania Avenue, Suite 7-420, Washington, D.C. 20037, USA.
authors.forename: Donald C
authors.initials: DC
authors.lastname: Shields
authors.affiliation: Department of Neurology, George Washington University, 2150 Pennsylvania Avenue, 9th Floor, Washington, D.C. 20037, USA. Electronic address: mkoubeissi@mfa.gwu.edu.
authors.forename: Mohamad Z
authors.initials: MZ
authors.lastname: Koubeissi
mesh_terms: D004558:Electric Stimulation; D004827:Epilepsy / Q000175:diagnosis; D005260:Female; D006801:Humans; D058542:Implantable Neurostimulators; D008875:Middle Aged; D011699:Putamen / Q000502:physiology*; D015000:Yawning / Q000502:physiology*
keywords: Electrical stimulation; Epilepsy; Insula; Putamen; Yawning