We describe a patient with advanced Parkinson’s disease who developed pathological gambling within a month after successful bilateral subthalamic nucleus (STN) stimulation. There was no history of gambling. On neuropsychological testing, slight cognitive decline was evident 1 year after surgery. Stimulation of the most dorsal contact with and without medication induced worse performances on decision making tests compared with the more ventral contact. Pathological gambling disappeared after discontinuation of pergolide and changing the stimulation parameters. Pathological gambling does not seem to be associated with decision making but appears to be related to a combination of bilateral STN stimulation and treatment with dopamine agonists.
- DBS, deep brain stimulation
- IGT, Iowa Gambling Task
- MCP, mid-commissural point
- PD, Parkinson’s disease
- STN, subthalamic nucleus
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Published Online First 8 January 2007
Competing interests: AEG receives salary support from a New Investigator grant from the National Center for Responsible Gambling, as provided by the Institute for Research on Pathological Gambling and Related Disorders (Harvard Medical School’s Division on Addictions). EMJF received a reimbursement for a lecture from Medtronic ltd. (Minneapolis). PRS received reimbursement from Medtronic Ltd for attending two conferences. JDS acts as an independent consultant for Medtronic Ltd. He has received travel grants from Medtronic Ltd.