The impact of mirth-inducing ventral striatal deep brain stimulation on functional and effective connectivity

William S. Gibson, Shinho Cho, Osama A. Abulseoud, Krzysztof R. Gorny, Joel P. Felmlee, Kirk M. Welker, Bryan T. Klassen, Hoon Ki Min, Kendall H. Lee

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) is an investigational therapy for treatmentresistant obsessive-compulsive disorder. The ability of VC/VS DBS to evoke spontaneous mirth in patients, often accompanied by smiling and laughter, is clinically well documented. However, the neural correlates of DBS-evoked mirth remain poorly characterized. Patients undergoing VC/VS DBS surgery underwent intraoperative evaluation in which mirth-inducing and nonmirth- inducing stimulation localizations were identified. Using dynamic causal modeling (DCM) for fMRI, the effect of mirthinducing DBS on functional and effective connectivity among established nodes in limbic cortico-striato-thalamo-cortical (CSTC) circuitry was investigated. Both mirth-inducing and non-mirth-inducing VC/VS DBS consistently resulted (conjunction, global null, family-wise error-corrected P < 0.05) in activation of amygdala, ventral striatum, and mediodorsal thalamus. However, only mirth-inducing DBS resulted in functional inhibition of anterior cingulate cortex. Dynamic causal modeling revealed that mirth-inducing DBS enhanced effective connectivity from anterior cingulate to ventral striatum, while attenuating connectivity from thalamus to ventral striatum relative to non-mirth-inducing stimulation. These results suggest that DBS-evoked mood elevation is accompanied by distinct patterns of limbic thalamocortical connectivity. Using the novel combination of DBS-evoked mood alteration and functional MRI in human subjects, we provide new insights into the networklevel mechanisms that influence affect.

Original languageEnglish (US)
Pages (from-to)2183-2194
Number of pages12
JournalCerebral Cortex
Issue number3
StatePublished - Mar 1 2017


  • DBS
  • FMRI
  • Mood
  • Nucleus accumbens
  • Obsessive compulsive disorder

ASJC Scopus subject areas

  • Cognitive Neuroscience
  • Cellular and Molecular Neuroscience


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