Clinical Neurophysiology
Volume 120, Issue 11 , Pages 1941-1948, November 2009

Functional topography of the ventral striatum and anterior limb of the internal capsule determined by electrical stimulation of awake patients

  • Andre Machado

      Affiliations

    • Center for Neurological Restoration, Department of Neurosurgery, Cleveland Clinic, 9500 Euclid Ave., Desk S31, Cleveland, OH 44195, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 216 444 4270; fax: +1 216 636 2989.
    • ,
  • Suzanne Haber

      Affiliations

    • Department of Pharmacology and Physiology, University of Rochester, Medical Center, USA
    • ,
  • Nathaniel Sears

      Affiliations

    • Department of Psychiatry and Human Behavior, Brown University, USA
    • ,
  • Benjamin Greenberg

      Affiliations

    • Brown University, USA
    • ,
  • Donald Malone

      Affiliations

    • Psychiatry Neuromodulation Center, Cleveland Clinic, USA
    • ,
  • Ali Rezai

      Affiliations

    • Department of Neurosurgery, Ohio State University, USA

Accepted 11 May 2009.

Abstract 

Objective

To assess the behavioral and subjective effects of acute electrical stimulation along the anterior limb of the internal capsule (ALIC) and ventral striatum (VS).

Methods

Intraoperative awake electrical stimulation and postoperative programming was performed in a group of 6 patients with major depressive disorder (MDD) undergoing bilateral deep brain stimulation of the ALIC and VS areas.

Results

Electrical stimulation of the VS area acutely produced changes in mood as well as alertness, anxiety, dizziness, sensation of warmth and “flushing”. Stimulation of the ventral capsule area just dorsal to the anterior commissure was associated with increments in mood, sensation of energy and alertness, laughing, calmness and talkative behavior. Behavioral effects were less commonly observed with stimulation of the dorsal region of the ALIC.

Conclusion

Acute behavioral and subjective responses can be consistently obtained from stimulation in the ventral ALIC and VS region. Positive changes in mood and anxiety were reproducibly elicited in the ventral ALIC area.

Significance

Intraoperative awake stimulation and postoperative programming of patients undergoing DBS for MDD provide unique opportunities to explore the subjective responses and behavioral phenomena related to electrical stimulation of the area spanning from the dorsal ALIC to the ventral striatum.

Keywords: Deep brain stimulation, Major depressive disorder, Orbitofrontal cortex, Ventral striatum, Internal capsule

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PII: S1388-2457(09)00493-3

doi:10.1016/j.clinph.2009.05.030

Clinical Neurophysiology
Volume 120, Issue 11 , Pages 1941-1948, November 2009

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