Mania Following Subthalamic Nucleus Stimulation for Parkinson’s Disease

Authors

  • Ana Patrícia Santos Velosa Departamento de Psiquiatria, Centro Hospitalar de Lisboa Ocidental e NOVA Medical School | Faculdade de Ciências Médicas - Universidade NOVA de Lisboa
  • Bruno Silva Departamento de Psiquiatria, Centro Hospitalar de Lisboa Ocidental e NOVA Medical School | Faculdade de Ciências Médicas - Universidade NOVA de Lisboa
  • Albino J. Oliveira-Maia Departamento de Psiquiatria, Centro Hospitalar de Lisboa Ocidental e NOVA Medical School | Faculdade de Ciências Médicas - Universidade NOVA de Lisboa
  • Paulo Bugalho Departamento de Neurologia, Centro Hospitalar de Lisboa Ocidental e NOVA Medical School | Faculdade de Ciências Médicas - Universidade NOVA de Lisboa
  • Bernardo Barahona-Correa Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unkown

DOI:

https://doi.org/10.25752/psi.18610

Keywords:

Mania, Deep Brain Stimulation, Sub Thalamic Nucleus, Parkinson Disease

Abstract

Background: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an effective treatment for advanced Parkinson’s disease. However,  important neuropsychiatric complications have been described, namely mania. The risk of post-DBS mania appears to be influenced by the stimulation target within the subthalamic nucleus (STN) and by the stimulation polarity and voltage. Concomitant medication may also increase this risk.

Aims: Report two cases of mania after STN--DBS.

Methods: Clinical case report and literature review.

Results and Conclusions: We describe two patients who developed de novo hypomania and mania after STN-DBS, associated with monopolar, high voltage stimulation in ventro-medial  areas of STN. Mania is an acute and serious complication of DBS-STN. Ventromedial, monopolar, high-voltage stimulation appears to increase the risk of mania, presumably due to the diffusion of stimulating energy to the neighbouring cortical-striatal limbic circuit. Early recognition and treatment of this complication is critical to a better prognosis.

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Published

2022-09-07

Issue

Vol. 17 No. 1&2 (2019)

Section

Case Reports

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