Manic behaviour induced by deep-brain stimulation in Parkinson's disease: evidence of substantia nigra implication?
Ulla M, Thobois S, Lemaire JJ, Schmitt A, Derost P, Broussolle E, Llorca PM, Durif F
Univ Clermont 1, UFR Médecine, Clermont-Ferrand, France. mulla@chu-clermontferrand.fr
We report the case of a patient who had benefited from bilateral subthalamic nucleus deep brain stimulation for Parkinson's disease and who presented acute and reproducible manic behaviour when stimulated mainly in the substantia nigra. A positron emission tomography scan showed an activation of the right dorsolateral prefrontal and inferior temporal cortex, the left anterior cingulate cortex and a deactivation of the left insula. This suggests that changes in cortical activation related to mania are subcortically driven, involving notably the substantia nigra.
Published 19 November 2006 in J Neurol Neurosurg Psychiatry, 77(12): 1363-6.
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