Evidence of a non-motor microlesion effect following deep brain surgery: a case report

Abstract

We report the case of a patient who developed acute transient psychosis after implantation, but not activation of pallidal deep brain electrodes for generalised dystonia. Psychotic symptoms coincided temporally with postoperative motor improvement induced by the microlesion effect after electode implantation. This finding suggests that the microlesion effect may not be confined to motor improvement, but also comprises non-motor symptoms. In our case, affection of adjacent dopaminergic fibres of passages has to be assumed.

Alterations of resting-state networks of Parkinson‘s disease patients after subthalamic DBS surgery

“…For example, using simultaneous MEG-DBS recordings in PD patients, Boon et al observed that rigidity and bradykinetic symptoms correlated with the whole-brain functional connectivity patterns, including connections between cortical and subcortical sensorimotor regions, albeit these patterns did not relate to tremor symptoms ( Boon et al, 2020 ). However, as we could detect significant changes in all four RSNs of interest, this suggests a wide-spread influence of the stun effect and supports the report of the stun effect not being limited to motor function ( Rozanski et al, 2012 ). Furthermore, the alteration of RSNs in disparate functional domains could be a predictor of side effects induced by STN-DBS ( Tamma et al, 2002 ).…”

Differential Diagnosis of Psychiatric Symptoms After Deep Brain Stimulation for Movement Disorders

“…Structural microlesions created by electrode placement are postulated to explain immediate benefit seen in patients' Parkinson's and tremor symptoms even before stimulation is applied . This “microlesion” hypothesis may also explain psychiatric symptoms occurring intra‐operatively and in the first postoperative days, such as psychosis, mania, apathy, and acute dementia .…”