Tags

Type your tag names separated by a space and hit enter

Deep brain stimulation of the ventral intermediate nucleus in patients with essential tremor: stimulation below intercommissural line is more efficient but equally effective as stimulation above.
Exp Neurol. 2011 Jul; 230(1):131-7.EN

Abstract

BACKGROUND

The posterior subthalamic area (PSA), ventral to the intercommissural line (ICL) and the ventral intermediate nucleus (VIM), has been suggested as a promising target for deep brain stimulation (DBS) in patients suffering from essential tremor (ET). In this study the clinical benefit of VIM and PSA DBS on postural tremor suppression was systematically evaluated in a two step approach with a 3D ultrasound kinematic analysis tool.

METHODS

We defined the exact position of 40 VIM-DBS-electrodes from 21 ET patients. In a first experiment with a subgroup of electrodes we subsequently activated a thalamic and a contact below ICL (sub-ICL) with equal parameter settings for within subject comparison. In a second step, we divided all electrodes into two groups, i.e. one group with activated thalamic and the other group with activated contacts below ICL and performed a group comparison under patients' individual stimulation parameters. Here, the corrected amplitude required for tremor suppression was analyzed separately for both groups.

RESULTS

Within subject comparison with equal parameter settings revealed a significant improvement of sub-ICL compared to thalamic stimulation. In contrast, group comparison under patients' individual stimulation did not show any significant difference in tremor suppression between VIM and PSA DBS. Although higher corrected stimulation amplitude was needed in the thalamic group this difference was not significant.

CONCLUSION

The data suggest that sub-ICL stimulation may be more efficient compared to thalamic stimulation but equally effective when patients' individual stimulation parameters are used.

Authors+Show Affiliations

Department of Neurology, University Hospital Cologne, Cologne, Germany. michael.barbe@uk-koeln.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21515262

Citation

Barbe, Michael T., et al. "Deep Brain Stimulation of the Ventral Intermediate Nucleus in Patients With Essential Tremor: Stimulation Below Intercommissural Line Is More Efficient but Equally Effective as Stimulation Above." Experimental Neurology, vol. 230, no. 1, 2011, pp. 131-7.
Barbe MT, Liebhart L, Runge M, et al. Deep brain stimulation of the ventral intermediate nucleus in patients with essential tremor: stimulation below intercommissural line is more efficient but equally effective as stimulation above. Exp Neurol. 2011;230(1):131-7.
Barbe, M. T., Liebhart, L., Runge, M., Deyng, J., Florin, E., Wojtecki, L., Schnitzler, A., Allert, N., Sturm, V., Fink, G. R., Maarouf, M., & Timmermann, L. (2011). Deep brain stimulation of the ventral intermediate nucleus in patients with essential tremor: stimulation below intercommissural line is more efficient but equally effective as stimulation above. Experimental Neurology, 230(1), 131-7. https://doi.org/10.1016/j.expneurol.2011.04.005
Barbe MT, et al. Deep Brain Stimulation of the Ventral Intermediate Nucleus in Patients With Essential Tremor: Stimulation Below Intercommissural Line Is More Efficient but Equally Effective as Stimulation Above. Exp Neurol. 2011;230(1):131-7. PubMed PMID: 21515262.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deep brain stimulation of the ventral intermediate nucleus in patients with essential tremor: stimulation below intercommissural line is more efficient but equally effective as stimulation above. AU - Barbe,Michael T, AU - Liebhart,Lena, AU - Runge,Matthias, AU - Deyng,Janina, AU - Florin,Esther, AU - Wojtecki,Lars, AU - Schnitzler,Alfons, AU - Allert,Niels, AU - Sturm,Volker, AU - Fink,Gereon R, AU - Maarouf,Mohammad, AU - Timmermann,Lars, Y1 - 2011/04/16/ PY - 2011/01/04/received PY - 2011/03/14/revised PY - 2011/04/07/accepted PY - 2011/4/26/entrez PY - 2011/4/26/pubmed PY - 2011/8/13/medline SP - 131 EP - 7 JF - Experimental neurology JO - Exp Neurol VL - 230 IS - 1 N2 - BACKGROUND: The posterior subthalamic area (PSA), ventral to the intercommissural line (ICL) and the ventral intermediate nucleus (VIM), has been suggested as a promising target for deep brain stimulation (DBS) in patients suffering from essential tremor (ET). In this study the clinical benefit of VIM and PSA DBS on postural tremor suppression was systematically evaluated in a two step approach with a 3D ultrasound kinematic analysis tool. METHODS: We defined the exact position of 40 VIM-DBS-electrodes from 21 ET patients. In a first experiment with a subgroup of electrodes we subsequently activated a thalamic and a contact below ICL (sub-ICL) with equal parameter settings for within subject comparison. In a second step, we divided all electrodes into two groups, i.e. one group with activated thalamic and the other group with activated contacts below ICL and performed a group comparison under patients' individual stimulation parameters. Here, the corrected amplitude required for tremor suppression was analyzed separately for both groups. RESULTS: Within subject comparison with equal parameter settings revealed a significant improvement of sub-ICL compared to thalamic stimulation. In contrast, group comparison under patients' individual stimulation did not show any significant difference in tremor suppression between VIM and PSA DBS. Although higher corrected stimulation amplitude was needed in the thalamic group this difference was not significant. CONCLUSION: The data suggest that sub-ICL stimulation may be more efficient compared to thalamic stimulation but equally effective when patients' individual stimulation parameters are used. SN - 1090-2430 UR - https://www.unboundmedicine.com/medline/citation/21515262/Deep_brain_stimulation_of_the_ventral_intermediate_nucleus_in_patients_with_essential_tremor:_stimulation_below_intercommissural_line_is_more_efficient_but_equally_effective_as_stimulation_above_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0014-4886(11)00119-1 DB - PRIME DP - Unbound Medicine ER -