脑部深刺激诱发的恐慌和恐惧  

Panic and fear induced by deep brain stimulation

作　　者：Shapira N.A. Okun M.S. Wint D. 王鹏 

机构地区：[1]University of Florida Brain Institute, Department of Neurology, 100 S Newell Drive, Gainesville, FL 32610, United States Dr.

出　　处：《世界核心医学期刊文摘（神经病学分册）》2006年第6期46-46,共1页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：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, fear ful, and described himself as having a “panic attack." His heart rate increased from 53 to 111. The effect (present with either device) was witnessed immediate ly after turning the device on, and abruptly ceased in the off condition. Conclu sions: DBS of the anterior limb of the internal capsule and nucleus accumbens re gion caused severe “panic." This response may result from activation of limbic and autonomic networks.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.

关 键 词：恐慌 恐惧 男性患者 深刺 脑部 内囊前肢 内侧苍白球 深部脑刺激 

分 类 号：R563.1[医药卫生—呼吸系统] R473.6[医药卫生—内科学]