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Deep brain stimulation of the subthalamic nucleus versus the zona incerta in the treatment of essential tremor.
Acta Neurochir (Wien). 2011 Dec; 153(12):2329-35.AN

Abstract

BACKGROUND

Deep brain stimulation (DBS) is an effective treatment for essential tremor (ET). Currently the ventrolateral thalamus is the target of choice, but the posterior subthalamic area (PSA), including the caudal zona incerta (cZi), has demonstrated promising results, and the subthalamic nucleus (STN) has been suggested as a third alternative. The objective of the current study was to evaluate the effect of STN DBS in ET and to compare this to cZi DBS.

METHODS

Four patients with ET were implanted with two ipsilateral electrodes, one in the STN and one in the cZi. All contacts were evaluated concerning the acute effect on tremor, and the effect of chronic DBS in either target was analyzed.

RESULTS

STN and cZi both proved to be potent targets for DBS in ET. DBS in the cZi was more efficient, since the same degree of tremor reduction could here be achieved at lower energy consumption. Three patients became tremor-free in the treated hand with either STN or cZi DBS, while the fourth had a minor residual tremor after stimulation in either target.

CONCLUSION

In this limited material, STN DBS was demonstrated to be an efficient treatment for ET, even though cZi DBS was more efficient. The STN may be an alternative target in the treatment of ET, pending further investigations to decide on the relative merits of the different targets.

Authors+Show Affiliations

Department of Clinical Neuroscience, section of Neurosurgery, Umeå University, Umeå, Sweden. patric.blomstedt@neuro.umu.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21904970

Citation

Blomstedt, Patric, et al. "Deep Brain Stimulation of the Subthalamic Nucleus Versus the Zona Incerta in the Treatment of Essential Tremor." Acta Neurochirurgica, vol. 153, no. 12, 2011, pp. 2329-35.
Blomstedt P, Sandvik U, Linder J, et al. Deep brain stimulation of the subthalamic nucleus versus the zona incerta in the treatment of essential tremor. Acta Neurochir (Wien). 2011;153(12):2329-35.
Blomstedt, P., Sandvik, U., Linder, J., Fredricks, A., Forsgren, L., & Hariz, M. I. (2011). Deep brain stimulation of the subthalamic nucleus versus the zona incerta in the treatment of essential tremor. Acta Neurochirurgica, 153(12), 2329-35. https://doi.org/10.1007/s00701-011-1157-4
Blomstedt P, et al. Deep Brain Stimulation of the Subthalamic Nucleus Versus the Zona Incerta in the Treatment of Essential Tremor. Acta Neurochir (Wien). 2011;153(12):2329-35. PubMed PMID: 21904970.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deep brain stimulation of the subthalamic nucleus versus the zona incerta in the treatment of essential tremor. AU - Blomstedt,Patric, AU - Sandvik,Ulrika, AU - Linder,Jan, AU - Fredricks,Anna, AU - Forsgren,Lars, AU - Hariz,Marwan I, Y1 - 2011/09/10/ PY - 2011/06/14/received PY - 2011/08/29/accepted PY - 2011/9/10/entrez PY - 2011/9/10/pubmed PY - 2012/8/18/medline SP - 2329 EP - 35 JF - Acta neurochirurgica JO - Acta Neurochir (Wien) VL - 153 IS - 12 N2 - BACKGROUND: Deep brain stimulation (DBS) is an effective treatment for essential tremor (ET). Currently the ventrolateral thalamus is the target of choice, but the posterior subthalamic area (PSA), including the caudal zona incerta (cZi), has demonstrated promising results, and the subthalamic nucleus (STN) has been suggested as a third alternative. The objective of the current study was to evaluate the effect of STN DBS in ET and to compare this to cZi DBS. METHODS: Four patients with ET were implanted with two ipsilateral electrodes, one in the STN and one in the cZi. All contacts were evaluated concerning the acute effect on tremor, and the effect of chronic DBS in either target was analyzed. RESULTS: STN and cZi both proved to be potent targets for DBS in ET. DBS in the cZi was more efficient, since the same degree of tremor reduction could here be achieved at lower energy consumption. Three patients became tremor-free in the treated hand with either STN or cZi DBS, while the fourth had a minor residual tremor after stimulation in either target. CONCLUSION: In this limited material, STN DBS was demonstrated to be an efficient treatment for ET, even though cZi DBS was more efficient. The STN may be an alternative target in the treatment of ET, pending further investigations to decide on the relative merits of the different targets. SN - 0942-0940 UR - https://www.unboundmedicine.com/medline/citation/21904970/Deep_brain_stimulation_of_the_subthalamic_nucleus_versus_the_zona_incerta_in_the_treatment_of_essential_tremor_ L2 - https://dx.doi.org/10.1007/s00701-011-1157-4 DB - PRIME DP - Unbound Medicine ER -