Clinical review of deep brain stimulation and its effects on limbic basal ganglia circuitry

This paper aims to provide an overview of factors that may contribute to cognitive and mood alterations following DBS (and lesion therapy). A PubMed search based on studies in the English-language was undertaken, and included all publications on the topics of mood and surgery for movement disorders. Information was collected on pre-operative and post-operative characteristics of each study, and study methodology was examined. One-hundred and forty published articles were selected and reviewed for mood and behavior changes following neurosurgery for movement disorders. There were a variety of mood and cognitive changes associated with DBS (and lesion therapy). These alterations of behavior and cognition were seen in all targets but not frequently reported with thalamic DBS. However methodological limitations, small sample sizes, lack of control groups, and the heterogeneity of data reported underscore why interpretation and comparison of limbic effects of DBS remains challenging. The collection and reporting of more standardized minimal data sets will allow for future comparisons, and improve the power required to answer many of the questions raised in this review.