A case of Parkinson's disease exhibiting hypersexuality after deep brain stimulation of the subthalamic nucleus

Abstract

A 73–year–old man began treatment with bilateral subthalamic deep brain stimulation (STN–DBS) 14 years after the onset of Parkinson's disease. After DBS, motor fluctuation and dyskinesia improved, and the dosage of anti–parkinson drugs was successfully decreased. However, eight months later, his wife complained of his hypersexuality that had not been present preoperatively. The symptom did not improve even after reduction of the dopamine agonist dose. The STN–DBS stimulation site was then changed from the ventral to the dorsal region, and his pathological hypersexuality resolved completely. In the context of our experience, this finding suggested that pathological hypersexuality may result from unnecessary stimulation to the limbic division by STN–DBS. Because it is a controllable symptom, hypersexuality should be evaluated in routine follow–up of patients treated with STN–DBS.