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Smile without euphoria induced by deep brain stimulation: a case report
Takashi Morishita1, Kelly D Foote, Derek B Archer
1a Department of Neurosurgery , Center for Movement Disorders and Neurorestoration, McKnight Brain Institute, University of Florida College of Medicine , Gainesville , FL , USA.
Neurocase
|November 1, 2014
Summary
Deep brain stimulation for poststroke central pain (PSCP) in one patient unexpectedly caused smiling without euphoria. This suggests potential differences in emotional pathways affected by PSCP treatments.
Area of Science:
- Neurology
- Neurosurgery
- Pain Medicine
Background:
- Poststroke central pain (PSCP) is a challenging condition often resistant to conventional treatments.
- Deep brain stimulation (DBS) is an emerging therapy for refractory neurological disorders.
Observation:
- A case report details a 69-year-old woman with medication-refractory PSCP, including dysesthesia, allodynia, and dystonia.
- The patient underwent right unilateral ventral capsule/ventral striatum (VC/VS) deep brain stimulation for PSCP.
Findings:
- VC/VS stimulation in this patient induced a distinct smile phenomenon.
- Crucially, this smile was not accompanied by any sensation of euphoria.
- This response differed from smile responses observed in obsessive-compulsive disorder patients undergoing similar stimulation.
Implications:
- The findings suggest that the emotional pathways involved in smile generation may be differentially affected in PSCP.
- This observation could inform future research into the neurobiology of emotional responses and pain.
- Further investigation is warranted to understand the specific neural mechanisms underlying this phenomenon.
