Reward Circuit DBS Improves Parkinson's Gait along with Severe Depression and OCD

Autor: Gregory L. Sahlem, Nolan R. Williams, Mark S. George, Istvan Takacs, E. Baron Short, Jonathan Snipes, Thomas Hopkins, Gonzalo J. Revuelta
Jazyk: angličtina
Rok vydání: 2015
Předmět:
0301 basic medicine
Male
medicine.medical_specialty
Obsessive-Compulsive Disorder
Parkinson's disease
Deep brain stimulation
medicine.medical_treatment
Deep Brain Stimulation
Apathy
behavioral disciplines and activities
Article
03 medical and health sciences
0302 clinical medicine
Physical medicine and rehabilitation
Arts and Humanities (miscellaneous)
Reward
Subthalamic Nucleus
medicine
Humans
Psychiatry
Depression (differential diagnoses)
Gait Disorders
Neurologic
Psychiatric Status Rating Scales
Depressive Disorder
Major
Ventral striatum
Parkinson Disease
Middle Aged
medicine.disease
Gait
nervous system diseases
Subthalamic nucleus
030104 developmental biology
medicine.anatomical_structure
surgical procedures
operative
Tolerability
nervous system
Neurology (clinical)
medicine.symptom
Psychology
therapeutics
030217 neurology & neurosurgery
Popis: A 59-year-old Caucasian man with a past history of Parkinson's disease (PD) status post-bilateral subthalamic nucleus (STN) deep brain stimulation (DBS), who also had treatment-resistant (TR) obsessive-compulsive disorder (OCD), and treatment-resistant depression (TRD), presented for further evaluation and management of his TR OCD. After an unsuccessful attempt to treat his OCD by reprogramming his existing STN DBS, he was offered bilateral ventral capsule/ventral striatum (VC/VS) DBS surgery. In addition to the expected improvement in OCD symptoms, he experienced significant improvement in both PD-related apathy and depression along with resolution of suicidal ideation. Furthermore, the patient's festinating gait dramatically improved. This case demonstrates that DBS of both the STN and VC/VS appears to have an initial signal of safety and tolerability. This is the first instance where both the STN and the VC/VS DBS targets have been implanted in an individual and the first case where a patient with PD has received additional DBS in mood-regulatory circuitry.
Databáze: OpenAIRE
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