Underlying neurobiology and clinical correlates of mania status after subthalamic nucleus deep brain stimulation in Parkinson's disease: a review of the literature

A Chopra, SJ Tye, KH Lee, S Sampson… - The Journal of …, 2012 - Am Neuropsych Assoc
A Chopra, SJ Tye, KH Lee, S Sampson, J Matsumoto, A Adams, B Klassen, M Stead…
The Journal of neuropsychiatry and clinical neurosciences, 2012Am Neuropsych Assoc
Deep brain stimulation (DBS) is a novel and effective surgical intervention for refractory
Parkinson's disease (PD). The authors review the current literature to identify the clinical
correlates associated with subthalamic nucleus (STN) DBS-induced hypomania/mania in
PD patients. Ventromedial electrode placement has been most consistently implicated in the
induction of STN DBS-induced mania. There is some evidence of symptom amelioration
when electrode placement is switched to a more dorsolateral contact. Additional clinical …
Deep brain stimulation (DBS) is a novel and effective surgical intervention for refractory Parkinson's disease (PD). The authors review the current literature to identify the clinical correlates associated with subthalamic nucleus (STN) DBS-induced hypomania/mania in PD patients. Ventromedial electrode placement has been most consistently implicated in the induction of STN DBS-induced mania. There is some evidence of symptom amelioration when electrode placement is switched to a more dorsolateral contact. Additional clinical correlates may include unipolar stimulation, higher voltage (>3 V), male sex, and/or early-onset PD. STN DBS-induced psychiatric adverse events emphasize the need for comprehensive psychiatric presurgical evaluation and follow-up in PD patients. Animal studies and prospective clinical research, combined with advanced neuroimaging techniques, are needed to identify clinical correlates and underlying neurobiological mechanisms of STN DBS-induced mania. Such working models would serve to further our understanding of the neurobiological underpinnings of mania and contribute valuable new insight toward development of future DBS mood-stabilization therapies.
The Journal of Neuropsychiatry and Clinical Neurosciences