Deep Brain Stimulation for Tremor: Is There a Common Structure?

Fiechter, Michael; Nowacki, Andreas; Oertel, Markus Florian; Fichtner, Jens; Debove, Ines; Lachenmayer, Lenard; Wiest, Roland; Bassetti, Claudio; Raabe, Andreas; Kaelin, Alain; Schüpbach, Michael; Pollo, Claudio (2017). Deep Brain Stimulation for Tremor: Is There a Common Structure? Stereotactic and functional neurosurgery, 95(4), pp. 243-250. Karger 10.1159/000478270

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BACKGROUND Subthalamic nucleus (STN) stimulation has been recognized to control resting tremor in Parkinson disease. Similarly, thalamic stimulation (ventral intermediate nucleus; VIM) has shown tremor control in Parkinson disease, essential, and intention tremors. Recently, stimulation of the posterior subthalamic area (PSA) has been associated with excellent tremor control. Thus, the optimal site of stimulation may be located in the surrounding white matter. AIMS The objective of this work was to investigate the area of stimulation by determining the contact location correlated with the best tremor control in STN/VIM patients. METHODS The mean stimulation site and related volume of tissue activated (VTA) of 25 tremor patients (STN or VIM) were projected on the Morel atlas and compared to stimulation sites from other tremor studies. RESULTS All patients showed a VTA that covered ≥50% of the area superior and medial to the STN or inferior to the VIM. Our stimulation areas suggest involvement of the more lateral and superior part of the dentato-rubro-thalamic tract (DRTT), whereas targets described in other studies seem to involve the DRTT in its more medial and inferior part when it crosses the PSA. CONCLUSIONS According to anatomical and diffusion tensor imaging data, the DRTT might be the common structure stimulated at different portions within the PSA/caudal zona incerta.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Fiechter, Michael; Nowacki, Andreas; Oertel, Markus Florian; Fichtner, Jens; Debove, Ines; Lachenmayer, Lenard; Wiest, Roland; Bassetti, Claudio; Raabe, Andreas; Kaelin, Alain; Schüpbach, Michael and Pollo, Claudio

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1011-6125

Publisher:

Karger

Language:

English

Submitter:

Stefanie Hetzenecker

Date Deposited:

13 Dec 2017 09:51

Last Modified:

23 Oct 2019 23:38

Publisher DOI:

10.1159/000478270

PubMed ID:

28772275

Uncontrolled Keywords:

Deep brain stimulation Dentato-rubro-thalamic tract Subthalamic nucleus Thalamic ventral intermediate nucleus Tremor

BORIS DOI:

10.7892/boris.106982

URI:

https://boris.unibe.ch/id/eprint/106982

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