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From the Parkinson and Movement Disorders Center (Dr. Bejjani), Byblos, Université Saint Joseph, Beirut, Lebanon; Centre d’Investigation Clinique Fédération de Neurologie (Drs. Houeto, Mesnage, Bonnet, and Agid), INSERM U289 and IFR 70 (Drs. Houeto, Yelnik, Bonnet, and Agid), Fédération de Neurophysiologie Clinique (Dr. Pidoux), Fédération de Neuroradiologie (Dr. Dormont), and Service de Neurochirurgie (Dr. Cornu), Hôpital Pitié-Salpêtrière, Paris, France; and Department of Clinical Neurosciences (Dr. Hariz), University Hospital of Northern Sweden, Umeå.
Address correspondence and reprint requests to Dr. Y. Agid, Centre d’Investigation Clinique, Hôpital de la Salpêtrière, 47 boulevard de l’Hôpital, 75013 Paris, France; e-mail: agid{at}ccr.jussieu.fr
The authors report a patient with advanced PD, successfully treated by bilateral stimulation of the subthalamic nucleus, who developed acute transient aggressive behavior during intraoperative electrical test stimulation. The electrode responsible for this abnormal behavior was located within the lateral part of the posteromedial hypothalamic region (triangle of Sano). The authors suggest that affect can be dramatically modulated by the selective manipulation of deep brain structures.
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