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Suicidal thoughts in patients with Parkinson’s disease treated by deep brain stimulation of the subthalamic nuclei: two case reports and review of the literature

Published online by Cambridge University Press:  24 June 2014

Yacov Balash ,
Doron Merims  and
Nir Giladi
Yacov Balash*
Affiliation:
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Doron Merims
Affiliation:
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Nir Giladi
Affiliation:
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
*
Dr Yacov Balash, Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv 64239, Israel. Tel: 972 3 6974914; Fax: 972 3 6974911; E-mail: [email protected]
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Abstract

Background:

Deep brain stimulation (DBS) of the subthalamic nuclei (STN) can result in depression despite the obvious motor improvement.

Case presentations:

Two patients with serious life-threatening depressive episodes are described. In the first case, the trigger for depression was a slight adjustment of the left stimulating electrode’s contact. In the second case, reducing both the dopaminergic therapy and the voltage of DBS resulted in the manifestation of depressive symptoms.

Conclusions:

DBS-induced depression possibly has pathogenetic differences from ordinary Parkinson’s disease depression. The STN region seems to be a sensitive zone that influences emotions.

Keywords

Parkinson’s diseasedeep brain stimulationsubthalamic nucleidepressionsuicidal thoughts
Type
Case report
Information
Acta Neuropsychiatrica , Volume 19 , Issue 3 , June 2007 , pp. 208 - 210
Copyright
Copyright © 2007 Blackwell Munksgaard

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References

Limousin, P, Krack, P, Pollak, Pet al. Electrical stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 1998;339:1105–1111.CrossRefGoogle ScholarPubMed
Krack, P, Batir, A, Van Blercom, Net al. Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 2003;349:1925–1934.CrossRefGoogle ScholarPubMed
Herzog, J, Volkmann, J, Krack, Pet al. Two-year follow-up of subthalamic deep brain stimulation in Parkinson’s disease. Mov Disord 2003;18:1332–1337.CrossRefGoogle ScholarPubMed
Berney, A, Vingerhoets, F, Perrin, Aet al. Effect on mood of subthalamic DBS for Parkinson’s disease: a consecutive series of 24 patients. Neurology 2002;59:1427–1429.CrossRefGoogle ScholarPubMed
Houeto, JL, Mesnage, V, Mallet, Let al. Behavioural disorders, Parkinson’s disease and subthalamic stimulation. J Neurol Neurosurg Psychiatry 2002;72:701–707.CrossRefGoogle ScholarPubMed
Doshi, PK, Chhaya, N, Bhatt, MH. Depression leading to attempted suicide after bilateral subthalamic nucleus stimulation for Parkinson’s disease. Mov Disord 2002;17:1084–1085.CrossRefGoogle ScholarPubMed
Burkhard, PR, Vingerhoes, FJG, Berney, Aet al. Suicides after successful deep brain stimulation for movement disorders. Neurology 2004;62 (Suppl. 5):A395.Google Scholar
Voon, V, Saint-Cyr, JA, Lozano, AMet al. Suicide risk in patients with Parkinson’s disease undergoing subthalamic stimulation. Mov Disord 2004;19:S323.Google Scholar
Myslobodsky, M, Lalonde, FM, Hicks, L. Are patients with Parkinson’s disease suicidal? J Geriatr Psychiatry Neurol 2001;14:120–124.CrossRefGoogle ScholarPubMed
Bejjani, BP, Damier, P, Arnulf, Iet al. Transient acute depression induced by high-frequency deep-brain stimulation. N Engl J Med 1999;340:1476–1480.CrossRefGoogle ScholarPubMed
Stefurak, T, Mikulis, D, Mayberg, Het al. Deep brain stimulation for Parkinson’s disease dissociates mood and motor circuits: a functional MRI case study. Mov Disord 2003;18:1508–1516.CrossRefGoogle ScholarPubMed
Kulisevsky, J, Berthier, ML, Gironell, Aet al. Mania following deep brain stimulation for Parkinson’s disease. Neurology 2002;59:1421–1424.CrossRefGoogle ScholarPubMed
Romito, LM, Raja, M, Daniele, Aet al. Transient mania with hypersexuality after surgery for high frequency stimulation of the subthalamic nucleus in Parkinson’s disease. Mov Disord 2002;17:1371–1374.CrossRefGoogle ScholarPubMed
Herzog, J, Reiff, J, Krack, Pet al. Manic episode with psychotic symptoms induced by subthalamic nucleus stimulation in a patient with Parkinson’s disease. Mov Disord 2003;18:1382–1384.CrossRefGoogle Scholar
Krack, P, Kumar, R, Ardouin, Cet al. Mirthful laughter induced by subthalamic nucleus stimulation. Mov Disord 2001;16:867–875.CrossRefGoogle ScholarPubMed
Okun, MS, Green, J, Saben, Ret al. Mood changes with deep brain stimulation of STN and GPi: results of a pilot study. J Neurol Neurosurg Psychiatry 2003;74:1584–1586.CrossRefGoogle ScholarPubMed
Koob, GF. Drugs of abuse: anatomy, pharmacology and function of reward pathways. Trends Pharmacol Sci 1992;13:177–184.CrossRefGoogle ScholarPubMed
Merims, D, Galili-Mosberg, R, Melamed, E. Is there addiction to levodopa in patients with Parkinson’s disease? Mov Disord 2000;15:1014–1016.3.0.CO;2-O>CrossRefGoogle ScholarPubMed
Lagopoulos, J, Malhi, GS, Ivanovski, B, Cahill, CM, Morris, JGL. A matter of motion or an emotional matter? Management of depression in Parkinson’s disease. Expert Rev Neurother 2005;5:803–810.CrossRefGoogle ScholarPubMed