Pathological crying induced by deep brain stimulation

Abstract

Pathological crying (PLC)--an affective gesture without any or an adequate emotion--occurs with various diseases. A recent theory suggests that PLC is caused by a disruption of higher order cortical association areas from the cerebellum which computes profiles of psychomotor responses. We report a patient with Parkinson's disease who developed PLC during stimulation of the subthalamic nucleus (STN) predominantly of the right hemisphere. Positron emission tomography imaging showed thalamo-ponto-cerebellar activation during such stimulation. These findings indicate that the STN and possibly also ponto-cerebellar pathways are involved in psychomotor control and in the modulation of PLC.