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Manic behaviour induced by deep-brain stimulation in Parkinson’s disease: evidence of substantia nigra implication?


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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