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Pharmacological treatment of deep brain stimulation-induced hypomania leads to clinical remission while preserving motor benefits
Authors:L. Schilbach  P. H. Weiss  J. Kuhn  L. Timmermann  J. Klosterkötter  W. Huff
Affiliation:1. Department of Psychiatry , University of Cologne , Cologne , Germany leonhard.schilbach@uk-koeln.de;3. Institute of Neuroscience and Medicine, Cognitive Neurology Section (INM-3), Research Center Juelich , Juelich , Germany;4. Department of Neurology , University of Cologne , Cologne , Germany;5. Department of Psychiatry , University of Cologne , Cologne , Germany;6. Department of Neurology , University of Cologne , Cologne , Germany
Abstract:Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for Parkinson's disease, but can lead to adverse effects including psychiatric disturbance. Little is known about the risk factors and treatment options for such effects. Here, we describe a patient who reproducibly developed stimulation-induced hypomania when using ventrally located electrodes and responded well to pharmacological intervention while leaving the stimulation parameters unchanged to preserve motor benefits. In spite of clinical remission, [15O]-positron-emission-tomography (PET) demonstrated activation patterns similar to those reported during mania. This case, therefore, highlights an important treatment option of adverse effects of DBS, but also points toward the need for investigations of its risk factors and their underlying neurobiological mechanisms.
Keywords:Subthalamic nucleus  Deep brain stimulation  Parkinson's disease  Stimulation-induced hypomania  Pharmacological treatment  Positron-emission-tomography (PET)
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