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

Abstract

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.

• Authors: Amit Chopra, Susannah J Tye, Kendall H Lee, Shirlene Sampson, Joseph Matsumoto, Andrea Adams, Bryan Klassen, Matt Stead, Julie A Fields, Mark A Frye
• Journal: The Journal of neuropsychiatry and clinical neurosciences (J Neuropsychiatry Clin Neurosci) Vol. 24 Issue 1 Pg. 102-10 ( 2012) ISSN: 1545-7222 [Electronic] United States
• PMID: 22450620 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)

Topics

• Bipolar Disorder (etiology)
• Deep Brain Stimulation (adverse effects)
• Humans
• MEDLINE (statistics & numerical data)
• Parkinson Disease (therapy)
• Subthalamic Nucleus (physiology)