Andre Machado1, Suzanne Haber2, Nathaniel Sears3, Benjamin Greenberg4, Donald Malone5, Ali Rezai6. 1. Center for Neurological Restoration, Department of Neurosurgery, Cleveland Clinic, 9500 Euclid Ave., Desk S31, Cleveland, OH 44195, USA. Electronic address: machada@ccf.org. 2. Department of Pharmacology and Physiology, University of Rochester, Medical Center, USA. 3. Department of Psychiatry and Human Behavior, Brown University, USA. 4. Brown University, USA. 5. Psychiatry Neuromodulation Center, Cleveland Clinic, USA. 6. Department of Neurosurgery, Ohio State University, USA.
Abstract
OBJECTIVE: To assess the behavioral and subjective effects of acute electrical stimulation along the anterior limb of the internal capsule (ALIC) and ventral striatum (VS). METHODS: Intraoperative awake electrical stimulation and postoperative programming was performed in a group of 6 patients with major depressive disorder (MDD) undergoing bilateral deep brain stimulation of the ALIC and VS areas. RESULTS: Electrical stimulation of the VS area acutely produced changes in mood as well as alertness, anxiety, dizziness, sensation of warmth and "flushing". Stimulation of the ventral capsule area just dorsal to the anterior commissure was associated with increments in mood, sensation of energy and alertness, laughing, calmness and talkative behavior. Behavioral effects were less commonly observed with stimulation of the dorsal region of the ALIC. CONCLUSION: Acute behavioral and subjective responses can be consistently obtained from stimulation in the ventral ALIC and VS region. Positive changes in mood and anxiety were reproducibly elicited in the ventral ALIC area. SIGNIFICANCE: Intraoperative awake stimulation and postoperative programming of patients undergoing DBS for MDD provide unique opportunities to explore the subjective responses and behavioral phenomena related to electrical stimulation of the area spanning from the dorsal ALIC to the ventral striatum.
OBJECTIVE: To assess the behavioral and subjective effects of acute electrical stimulation along the anterior limb of the internal capsule (ALIC) and ventral striatum (VS). METHODS: Intraoperative awake electrical stimulation and postoperative programming was performed in a group of 6 patients with major depressive disorder (MDD) undergoing bilateral deep brain stimulation of the ALIC and VS areas. RESULTS: Electrical stimulation of the VS area acutely produced changes in mood as well as alertness, anxiety, dizziness, sensation of warmth and "flushing". Stimulation of the ventral capsule area just dorsal to the anterior commissure was associated with increments in mood, sensation of energy and alertness, laughing, calmness and talkative behavior. Behavioral effects were less commonly observed with stimulation of the dorsal region of the ALIC. CONCLUSION: Acute behavioral and subjective responses can be consistently obtained from stimulation in the ventral ALIC and VS region. Positive changes in mood and anxiety were reproducibly elicited in the ventral ALIC area. SIGNIFICANCE: Intraoperative awake stimulation and postoperative programming of patients undergoing DBS for MDD provide unique opportunities to explore the subjective responses and behavioral phenomena related to electrical stimulation of the area spanning from the dorsal ALIC to the ventral striatum.
Authors: J Luis Lujan; Ashutosh Chaturvedi; Donald A Malone; Ali R Rezai; Andre G Machado; Cameron C McIntyre Journal: Hum Brain Mapp Date: 2011-04-21 Impact factor: 5.038