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J Neurol Neurosurg Psychiatry doi:10.1136/jnnp.2006.102061

Pathological gambling after bilateral STN stimulation in Parkinson disease

  1. HMM Smeding (h.m.smeding{at}amc.uva.nl)
  1. Academic Medical Center Amsterdam, Netherlands
    1. AE Goudriaan (goudriaana{at}missouri.edu)
    1. Amsterdam Institute for Addiction Research, Netherlands
      1. EMJ Foncke (e.m.foncke{at}amc.uva.nl)
      1. Academic Medical Center Amsterdam, Netherlands
        1. PR Schuurman (p.r.schuurman{at}amc.uva.nl)
        1. Academic Medical Center Amsterdam, Netherlands
          1. JD Speelman (j.d.speelman{at}amc.uva.nl)
          1. Academic Medical Center Amsterdam, Netherlands
            1. B Schmand (b.schmand{at}amc.uva.nl)
            1. Academic Med Center/Univ of Amsterdam, Netherlands
              • Published Online First 8 January 2007

              Abstract

              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 a year after surgery. Stimulation of the most dorsal contact with and without medication induced worse performances on decision-making tests compared to the more ventral contact. Pathological gambling disappeared after discontinuation of pergolide and changing the stimulation parameters. Pathological gambling does not seem to be related to decision-making but appears to be related to a combination of bilateral STN stimulation and treatment with dopamine agonists.

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