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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Competing interests: None declared.
Consent was obtained for publication of the patient’s details described in this report.