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BACKGROUND Mood, cognitive, and behavioural changes have been reported with deep brain stimulation (DBS) in the thalamus, globus pallidus interna, and anterior limb of the internal capsule/nucleus accumbens region. OBJECTIVE To investigate panic and fear resulting from DBS. METHODS Intraoperative DBS in the region of the right and then left anterior limb of the internal capsule and nucleus accumbens region was undertaken to treat a 52 year old man with treatment refractory obsessive-compulsive disorder (OCD). Mood, anxiety, OCD, alertness, heart rate, and subjective feelings were recorded during intraoperative test stimulation and at follow up programming sessions. RESULTS DBS at the distal (0) contact (cathode 0-, anode 2+, pulse width 210 ms, rate 135 Hz, at 6 volts) elicited a panic attack (only seen at the (0) contact). The patient felt flushed, hot, fearful, and described himself as having a "panic attack." His heart rate increased from 53 to 111. The effect (present with either device) was witnessed immediately after turning the device on, and abruptly ceased in the off condition CONCLUSIONS DBS of the anterior limb of the internal capsule and nucleus accumbens region caused severe "panic." This response may result from activation of limbic and autonomic networks.
N A Shapira, and
M S Okun, and
D Wint, and
K D Foote, and
J A Byars, and
D Bowers, and
U S Springer, and
P J Lang, and
B D Greenberg, and
S N Haber, and
W K Goodman
April 2016,
Parkinsonism & related disorders,
N A Shapira, and
M S Okun, and
D Wint, and
K D Foote, and
J A Byars, and
D Bowers, and
U S Springer, and
P J Lang, and
B D Greenberg, and
S N Haber, and
W K Goodman
July 2007,
Movement disorders : official journal of the Movement Disorder Society,
N A Shapira, and
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D Wint, and
K D Foote, and
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D Bowers, and
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P J Lang, and
B D Greenberg, and
S N Haber, and
W K Goodman
March 2020,
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology,
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Journal of neural transmission (Vienna, Austria : 1996),
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B D Greenberg, and
S N Haber, and
W K Goodman
January 2008,
Annals of neurology,
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S N Haber, and
W K Goodman
December 2000,
Epilepsia,
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September 2002,
Epilepsy currents,
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W K Goodman
May 1999,
The New England journal of medicine,
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S N Haber, and
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B D Greenberg, and
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