Can you induce an elevated mood by subthalamic nucleus deep brain stimulation (STN DBS) settings? You bet you can and Coutinho, Johnson, de Hemptinne and colleagues share a great case @tremorjournal. Key Points: - The authors remind us that STN DBS may occasionally be associated with 'undesirable psychiatric adverse effects, including elevated mood.' - This person had bilateral STN DBS and experienced stimulation-induced elevated mood. - There was a correlation between 'mood changes and enhanced activation of the ventromedial region of the left STN DBS.' My take: These episodes trevealed stimulation-induced events which manifested contemporaneously or shortly following DBS programming. The authors point out that there may have been a risk factor in the baseline mild impulse control symptoms and hypersexuality. Because episodes of mood elevation were 'acute, reversible, and associated with changes in stimulation parameters' this phenomenon will be important for clinicians to appreciate. Additionally, reductions in levodopa therapy may also be useful in the management process. Clinicians should also be aware that mood elevation and hypomania may occur following DBS, and if you have yet to encounter a case, consider the possibility you may have missed the diagnosis. My advice for clinicians managing folks in the first few weeks/months following DBS surgery is to approach management of the case w/ arrectīs auribus – w/ ears pricked up, for hints that the 'response to therapy may be too good' (e.g. euphoria, hypomania, euphoria). tremorjournal.org/articles/1… #Parkinsons @DBSThinkTank #Subthalamic #deepbrainstimulation