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Deep Brain Stimulation for Obsessive-Compulsive Disorder Affects Language: A Case Report

Polak, A. Rosaura MSc*; Witteveen, Anke B. PhD*; Mantione, Mariska MSc*; Figee, Martijn MD*; de Koning, Pelle MD*; Olff, Miranda PhD*,‡; van den Munckhof, Pepijn MD, PhD§; Schuurman, P. Richard MD, PhD§; Denys, Damiaan MD, PhD*,¶

doi: 10.1227/NEU.0000000000000022
Case Report

BACKGROUND AND IMPORTANCE: Deep brain stimulation (DBS) is an effective treatment for patients with refractory neuropsychiatric disorders. Along with symptom improvement, DBS may have concurrent behavioral effects that help to unravel the role of specific brain circuitries in complex human behavior.

CLINICAL PRESENTATION: This article reports on 2 patients with obsessive-compulsive disorder who received DBS targeted at the nucleus accumbens that resulted in a temporary change of accent and use of vocabulary.

CONCLUSION: Changes in accent and speaking manners are most likely related to direct DBS stimulation effects of the electrode targeted at the nucleus accumbens. The shift in accent, resembling foreign accent syndrome after injuries in brain language centers, has not been reported before in the course of DBS. Induction of aggressive vocabulary may be related to transient hypomanic behavior after DBS.

ABBREVIATIONS: DBS, deep brain stimulation

FAS, foreign accent syndrome

NAc, nucleus accumbens

OCD, obsessive-compulsive disorder

vALIC, ventral part of the anterior limb of the internal capsule

*Department of Psychiatry and

§Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands;

Arq Psychotrauma Expert Group, Diemen, the Netherlands;

Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands

Correspondence: A. Rosaura Polak, MSc, Department of Psychiatry, AMC (PA.3-130), University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, Netherlands. E-mail: a.r.polak@amc.uva.nl; or Damiaan Denys, MD, PhD, Department of Psychiatry, AMC (PA.2-179), University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, Netherlands. E-mail: ddenys@gmail.com

Received October 29, 2012

Accepted May 31, 2013

Copyright © by the Congress of Neurological Surgeons