ELECTRICALSELF-STIMULATIONOFTHE
BRAIN
IN4
1
571
ROBERTC.HEATH,M.D.2’3
Atasymposiumconcerningdepthelec-trode
studiesin
animals
andmaninNewOrleansin1952,theTulaneinvestigatorsdescribed(and
illustrated
with
films
ofpa-
tientstreatedbetween1950-1952)apleas-
urable
responsewithstimulation
of
specificregions
ofthe
brain(5).
The
pleasurablere-
sponse
tostimulation
ofsomedeepregions
of‘thebrain,firstobserved
withelectrical
stimulation
tothe
septalregion,hasproved
aconsistent
finding
in
continuingstudies(6,
7,
12).Since1952wehavereported
various
aspectsofthephenomenonincludingdem-onstrationofreliefofphysicalpainbystim-ulationto
this
pleasure-yieldingareaofthebrain(11).Withthe
introductionofingenious
techniquesforself-stimulationbyOlds(14-17),theneedtodependlargelyuponverbal
reports
ofthesubjectiveresponsewaseliminatedanditwaspossibletostudyapparentrewardandaversiveareasofthe
brain
inanimals.Subjectivedata,ofcourse,werelackingintheanimalstudies.
During
thelastfewyearstheTulaneresearchershaveincorporatedandmodifiedsomeanimalintracranialself-stimulation(ICSS)
methods
for
humaninvestigation,permittingextensionofthe
pleasurable
phenomenonstudiesinman.AnICSSstudy
recentlypublished(3)
was
designedtoex-plorehumanbehavior
under
strictlabo-ratoryconditionsofthe
type
characteristic-allyemployedinanimalstudies.Astudyhasalsobeendescribedinwhichapatient
1Readatthe
119thannualmeeting
of
TheAmerican
PsychiatricAssociation,
St
Louis,
Mo.,
May
6-10,1963.
At
thetimeof
presentation,a
16
mm.
soundfilmwas
shown
demonstrating
the
effects
of
stimulation
bythetransistorizedportableself-stimulatortoanumberofspecificregionsofthebrain
in
PatientsNo.B-7andNo.
B-b.The
twosubjectswereinterviewedtoobtainsubjectivedescriptionsoftheeffectsofstimulation.SupportedbyfundsprovidedbytheLouisianaStateDepartmentofHospitals.2Dept.ofPsychiatryandNeurology,Tulane
University
SchoolofMedicine,NewOrleans,La.
3Charles
J.
Fontana,
Electroencephalographic
Technologist
and
Esther
Blount,
R.N.,Research
Nurse,Assistants.
wasequippedwithasmallportableself-
stimulatorwith
3buttons,permittingdeliv-ery
ofelectricalstimuli
of
fixedparameters
toanyoneof3brainsites(8).The
pri-mary
motivationinthesestudies,asinalldepthelectrodestudiesinmanatTulane,wastherapeutic(5).Studyofrewardareasinthe
brain
ofman,including
use
ofinducedrewardfortherapeuticpurposes,isextensiveandcom-plex.Thispresentationwillfocusonade-
scriptionofthesubjectiveresponses
oftwo
patients‘treatedbytheself-stimula-
tiontechnique.Theirreportsprovidein-formation
concerning
thereasonsforre-peated
ICSS-informationthatis
not
avail-
ablefromanimalstudies.
MATERIAL
ANDMETHODS
Twopatientswereusedinthe
study.
PatientNo.B-7,age28,withadiagnosisofnarcolepsyand
cataplexy,
had
failed
torespondtoconventionaltreatments.Hehadelectrodesimplantedbythemethoddevelopedinour
laboratory(
1,2)into14
predetermined
brainregionsandfixedto
remain
inexactpositionforprolonged
study.Thesesmallsilverballelectrodes
(mostofthoseusedinthis
studyconsisted
of3leadseachseparatedby2
mm.)were
placedintotherightanterior
andposterior
septalregion,leftanteriorandposterior
septalregion,rightanteriorhypothalamus,mid-linemesencephalictegmentum,
leftanteriorandposteriorhippocampus,
left
anterior
and
posterior
caudatenucleusandoverthe
right
frontal
cortex,right
andleftmid-temporalcortex,andleftan-teriortemporalcortex.
PatientNo.B-10,age25,apsychomotor
epileptic
with
episodicbriefperiods
ofim-
pulsivebehavioruncontrolled
withthe
usualtreatments,
had51leads
implanted
into17brainsites:leftandright
centro-
median,leftcaudatenucleus,
right
yen-tricle,leftandrighthippocampus,mid-
line
mesencephalictegmentum,leftand
right
septalregion,leftamygdaloidnucleus,leftparaolfactoryarea,andovertheleft
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