Compulsive thalamic self-stimulation: A case with metabolic, electrophysiologic and behavioral correlates Journal Article

  


Authors: Portenoy, R. K.; Jarden, J. O.; Sidtis, J. J.; Lipton, R. B.; Foley, K. M.; Rottenberg, D. A.
Article Title: Compulsive thalamic self-stimulation: A case with metabolic, electrophysiologic and behavioral correlates
Abstract: A 48-year-old woman with a stimulating electrode implanted in the right thalamic nucleus ventralis posterolateralis developed compulsive self-stimulation associated with erotic sensations and changes in autonomic and neurologic function. Stimulation effects were evaluated by neuropsychologic testing, endocrine studies, positron emission tomographic measurements of regional cerebral metabolic rate for glucose, EEG and evoked potentials. During stimulation, vital signs and pupillary diameter increased and a left hemiparesis and left hemisensory loss developed. Verbal functions deteriorated and visuospatial processing improved. Plasma growth hormone concentrations decreased, and adrenocorticotrophic hormone and cortisol levels rose. With stimulation, glucose metabolism increased in both thalami and both hemispheres, reversing baseline right-sided hypometabolism and right-left asymmetries. EEG and both somatosensory and brain-stem auditory evoked potentials remained unchanged during stimulation, while visual evoked potentials revealed evidence of anterior visual pathway dysfunction in the left eye. This case establishes the potential for addiction to deep brain stimulation and demonstrates that widespread behavioral and physiological changes, with concomitant alteration in the regional cerebral metabolic rate for glucose, may accompany unilateral thalamic stimulation. © 1986.
Keywords: middle aged; case report; metabolism; pain; growth hormone; central nervous system; psychological aspect; brain; fluorodeoxyglucose f18; neuropsychological tests; behavior; glucose; hydrocortisone; analgesia; electrophysiology; therapy; sexual behavior; hormones; tomography, emission-computed; nervous system; evoked response; evoked potentials; brain depth stimulation; corticotropin; thalamus; brain metabolism; compulsive behavior; deoxyglucose; self stimulation; humans; human; female; priority journal; article; deep brain stimulation; self-stimulation; compulsion; thalamus ventral nucleus; thalamic nuclei
Journal Title: Pain
Volume: 27
Issue: 3
ISSN: 0304-3959
Publisher: Elsevier Science BV  
Date Published: 1986-12-01
Start Page: 277
End Page: 290
Language: English
DOI: 10.1016/0304-3959(86)90155-7
PUBMED: 3492699
PROVIDER: scopus
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-0022889762&doi=10.1016%2f0304-3959%2886%2990155-7&partnerID=40&md5=8e0ba8e82ef93697a9a51d712a537f2e
Notes: Article -- Export Date: 18 August 2021 -- Source: Scopus
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MSK Authors
  1. Kathleen M Foley
    199 Foley
  2. Russell K. Portenoy
    165 Portenoy
  3. David A. Rottenberg
    41 Rottenberg
  4. John J. Sidtis
    18 Sidtis
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