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Manic behaviour induced by deep-brain stimulation in Parkinson’s disease: evidence of substantia nigra implication?
  1. M Ulla1,
  2. S Thobois2,
  3. J-J Lemaire3,
  4. A Schmitt4,
  5. P Derost5,
  6. E Broussolle2,
  7. P-M Llorca4,
  8. F Durif5
  1. 1Univ Clermont 1, UFR Médecine, Clermont-Ferrand, France
  2. 2CHU Lyon, Hôpital Neurologique Pierre Wertheimer, Service de Neurologie D, Lyon, France
  3. 3CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Service de Neurochirurgie A, Clermont-Ferrand
  4. 4CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Service de Psychiatrie B
  5. 5CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Service de Neurologie A
  1. Correspondence to:
 M Ulla
 Service de Neurologie A, CHU Clermont-Ferrand, Hôpital Gabriel Montpied, rue Montalembert, F-63003 Clermont-Ferrand, France; mulla{at}chu-clermontferrand.fr

Abstract

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.

  • DBS, deep-brain stimulation
  • DSM IV, Diagnostic and statistical manual—4th edn
  • HFS, high-frequency stimulation
  • MRI, magnetic resonance imaging
  • PET, positron emission tomography
  • rCBF, regional cerebral blood flow
  • STN, subthalamic nucleus

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Footnotes

  • Competing interests: None declared.

  • Consent was obtained for publication of the patient’s details described in this report.

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