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Deep Brain Stimulation of the Caudal Zona Incerta: Tremor Control in Relation to the Location of Stimulation Fields.
Stereotact Funct Neurosurg. 2016; 94(6):363-370.SF

Abstract

BACKGROUND

The caudal zona incerta (cZi) and posterior subthalamic area (PSA) are an emerging deep brain stimulation (DBS) target for essential tremor (ET).

OBJECTIVES

To evaluate the efficacy of tremor control in relation to the anatomical locations of stimulation fields in 50 patients with ET and DBS of the cZi.

METHODS

A total of 240 contacts were evaluated separately with monopolar stimulation, and amplitudes were optimized for improvement of tremor and hand function. Stimulation fields, i.e., volumes of neural activation, were simulated for each optimized setting and assembled into probabilistic stimulation maps (PSMs).

RESULTS

There were differences in the anatomical distribution of PSMs associated with good versus poor tremor control. The location of PSMs which achieved good and excellent tremor control corresponded well with the PSM for the clinically used settings, and they were located within the superior part of the PSA.

CONCLUSIONS

PSMs may serve as a useful tool for defining the most efficacious anatomical location of stimulation. The best tremor control in this series of cZi DBS was achieved with stimulation of the superior part of the PSA, which corresponds to the final part of the cerebellothalamic projections before they reach the ventral lateral thalamus.

Authors+Show Affiliations

Unit of Functional and Stereotactic Neurosurgery, Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27784023

Citation

Fytagoridis, Anders, et al. "Deep Brain Stimulation of the Caudal Zona Incerta: Tremor Control in Relation to the Location of Stimulation Fields." Stereotactic and Functional Neurosurgery, vol. 94, no. 6, 2016, pp. 363-370.
Fytagoridis A, Åström M, Samuelsson J, et al. Deep Brain Stimulation of the Caudal Zona Incerta: Tremor Control in Relation to the Location of Stimulation Fields. Stereotact Funct Neurosurg. 2016;94(6):363-370.
Fytagoridis, A., Åström, M., Samuelsson, J., & Blomstedt, P. (2016). Deep Brain Stimulation of the Caudal Zona Incerta: Tremor Control in Relation to the Location of Stimulation Fields. Stereotactic and Functional Neurosurgery, 94(6), 363-370. https://doi.org/10.1159/000448926
Fytagoridis A, et al. Deep Brain Stimulation of the Caudal Zona Incerta: Tremor Control in Relation to the Location of Stimulation Fields. Stereotact Funct Neurosurg. 2016;94(6):363-370. PubMed PMID: 27784023.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deep Brain Stimulation of the Caudal Zona Incerta: Tremor Control in Relation to the Location of Stimulation Fields. AU - Fytagoridis,Anders, AU - Åström,Mattias, AU - Samuelsson,Jennifer, AU - Blomstedt,Patric, Y1 - 2016/10/27/ PY - 2016/01/26/received PY - 2016/08/04/accepted PY - 2016/10/27/pubmed PY - 2018/2/6/medline PY - 2016/10/27/entrez SP - 363 EP - 370 JF - Stereotactic and functional neurosurgery JO - Stereotact Funct Neurosurg VL - 94 IS - 6 N2 - BACKGROUND: The caudal zona incerta (cZi) and posterior subthalamic area (PSA) are an emerging deep brain stimulation (DBS) target for essential tremor (ET). OBJECTIVES: To evaluate the efficacy of tremor control in relation to the anatomical locations of stimulation fields in 50 patients with ET and DBS of the cZi. METHODS: A total of 240 contacts were evaluated separately with monopolar stimulation, and amplitudes were optimized for improvement of tremor and hand function. Stimulation fields, i.e., volumes of neural activation, were simulated for each optimized setting and assembled into probabilistic stimulation maps (PSMs). RESULTS: There were differences in the anatomical distribution of PSMs associated with good versus poor tremor control. The location of PSMs which achieved good and excellent tremor control corresponded well with the PSM for the clinically used settings, and they were located within the superior part of the PSA. CONCLUSIONS: PSMs may serve as a useful tool for defining the most efficacious anatomical location of stimulation. The best tremor control in this series of cZi DBS was achieved with stimulation of the superior part of the PSA, which corresponds to the final part of the cerebellothalamic projections before they reach the ventral lateral thalamus. SN - 1423-0372 UR - https://www.unboundmedicine.com/medline/citation/27784023/Deep_Brain_Stimulation_of_the_Caudal_Zona_Incerta:_Tremor_Control_in_Relation_to_the_Location_of_Stimulation_Fields_ L2 - https://www.karger.com?DOI=10.1159/000448926 DB - PRIME DP - Unbound Medicine ER -