Compulsive thalamic self-stimulation

A case with metabolic, electrophysiologic and behavioral correlates

Russell K. Portenoy, Jens O. Jarden, John J. Sidtis, Richard B. Lipton, Kathleen M. Foley, David A. Rottenberg

Research output: Contribution to journalArticle

16 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)277-290
Number of pages14
JournalPain
Volume27
Issue number3
DOIs
StatePublished - 1986

Fingerprint

Self Stimulation
Glucose
Electroencephalography
Ventral Thalamic Nuclei
Thalamic Nuclei
Implanted Electrodes
Deep Brain Stimulation
Visual Pathways
Visual Evoked Potentials
Brain Stem Auditory Evoked Potentials
Vital Signs
Autonomic Nervous System
Paresis
Thalamus
Evoked Potentials
Adrenocorticotropic Hormone
Growth Hormone
Hydrocortisone
Electrons

Keywords

  • deep brain stimulation
  • self-stimulation
  • thalamus

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Neuroscience(all)
  • Neurology
  • Pharmacology
  • Clinical Psychology

Cite this

Compulsive thalamic self-stimulation : A case with metabolic, electrophysiologic and behavioral correlates. / Portenoy, Russell K.; Jarden, Jens O.; Sidtis, John J.; Lipton, Richard B.; Foley, Kathleen M.; Rottenberg, David A.

In: Pain, Vol. 27, No. 3, 1986, p. 277-290.

Research output: Contribution to journalArticle

Portenoy, Russell K. ; Jarden, Jens O. ; Sidtis, John J. ; Lipton, Richard B. ; Foley, Kathleen M. ; Rottenberg, David A. / Compulsive thalamic self-stimulation : A case with metabolic, electrophysiologic and behavioral correlates. In: Pain. 1986 ; Vol. 27, No. 3. pp. 277-290.
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