Clin Psychopharmacol Neurosci 2018; 16(4): 494-496  
Turning on the Left Side Electrode Changed Depressive State to Manic State in a Parkinson’s Disease Patient Who Received Bilateral Subthalamic Nucleus Deep Brain Stimulation: A Case Report
Makoto Kinoshita1, Masahito Nakataki1, Ryoma Morigaki2,3,6, Satsuki Sumitani1,4, Satoshi Goto2,6, Ryuji Kaji5,6, Tetsuro Ohmori1
Departments of 1Psychiatry, 2Neurodegenerative Disorders Research, 3Neurosurgery, 4Support for Students with Special Needs, and 5Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, 6Parkinson’s Disease and Dystonia Research Center, Tokushima University Hospital, Tokushima University, Tokushima, Japan
Correspondence to: Makoto Kinoshita, MD, PhD
Department of Psychiatry, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15, Kuramoto, Tokushima 770-8503, Japan
Tel: +81-88-633-7130, Fax: +81-88-633-7131
E-mail: knst5511mkt@sunny.ocn.ne.jp
Received: January 10, 2017; Revised: February 24, 2017; Accepted: March 20, 2017; Published online: November 30, 2018.
© The Korean College of Neuropsychopharmacology. All rights reserved.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
No previous reports have described a case in which deep brain stimulation elicited an acute mood swing from a depressive to manic state simply by switching one side of the bilateral deep brain stimulation electrode on and off. The patient was a 68-year-old woman with a 10-year history of Parkinson’s disease. She underwent bilateral subthalamic deep brain stimulation surgery. After undergoing surgery, the patient exhibited hyperthymia. She was scheduled for admission. On the first day of admission, it was clear that resting tremors in the right limbs had relapsed and her hyperthymia had reverted to depression. It was discovered that the left-side electrode of the deep brain stimulation device was found to be accidentally turned off. As soon as the electrode was turned on, motor impairment improved and her mood switched from depression to mania. The authors speculate that the lateral balance of stimulation plays an important role in mood regulation. The current report provides an intriguing insight into possible mechanisms of mood swing in mood disorders.
Keywords: Subthalamic nucleus deep brain stimulation; Parkinson’s disease; Manic episode; Depressive episode; Lateral balance.


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