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Simultaneous Thalamic and Posterior Subthalamic Electrode Insertion With Single Deep Brain Stimulation Electrode for Essential Tremor

 Won Seok Chang  ;  Jong Chul Chung  ;  Joo Pyung Kim  ;  Jin Woo Chang 
 NEUROMODULATION, Vol.16(3) : 236-243, 2013 
Journal Title
Issue Date
Aged ; Deep Brain Stimulation/instrumentation* ; Deep Brain Stimulation/methods* ; Disability Evaluation ; Electrodes, Implanted* ; Essential Tremor/therapy* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Severity of Illness Index ; Statistics, Nonparametric ; Subthalamic Nucleus/physiology* ; Thalamus/physiology* ; Treatment Outcome
Deep brain stimulation ; essential tremor ; posterior subthalamic area ; ventralis intermedius nucleus of thalamus
Objectives:  The optimal target location of deep brain stimulation (DBS) is the subject of some controversy. We implanted electrodes that could stimulate both posterior subthalamic area (PSA) and ventralis intermedius nucleus of thalamus (Vim), and examined the benefits of bilateral DBS of Vim, PSA, and Vim + PSA in patients with essential tremor (ET). Materials and Methods:  Electrodes were inserted into the Vim and PSA in ten hemispheres of five consecutive patients. All patients were assessed for action tremor, including postural and kinetic tremors, both preoperatively and at six months and one year postoperatively. Results:  The preoperative mean postural tremor score was 1.9 (range 1.0–2.5) and kinetic tremor score was 2.6 (range 2.0–3.0). One year after surgery, these scores had decreased significantly to 0.1 (range 0.0–1.0) and 0.6 (range 0.0–1.5), respectively. The postural and kinetic tremor scores at six-months and one-year post-surgery were similar for Vim, PSA, and Vim + PSA stimulation. Conclusions:  We were able to identify the optimal electrode placement site for each patient based on his or her individualized response to the stimulation. Overall, there was no statistically significant difference among the DBS sites in terms of the benefits afforded by the stimulation. We propose that our technique may be a useful surgical method to treat ET.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Joo Pyung(김주평)
Chang, Won Seok(장원석) ORCID logo https://orcid.org/0000-0003-3145-4016
Chang, Jin Woo(장진우) ORCID logo https://orcid.org/0000-0002-2717-0101
Chung, Jong Chul(정종철)
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