Deep brain stimulation of the ventrolateral thalamic base and posterior subthalamic area in dystonic head tremor
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Deep brain stimulation of the ventrolateral thalamic base and posterior subthalamic area in dystonic head tremor. / Buhmann, Carsten; Moll, Christian K E; Zittel-Dirks, Simone; Münchau, Alexander; Engel, Andreas K; Hamel, Wolfgang.
In: ACTA NEUROCHIR SUPPL, Vol. 117, 01.01.2013, p. 67-72.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Deep brain stimulation of the ventrolateral thalamic base and posterior subthalamic area in dystonic head tremor
AU - Buhmann, Carsten
AU - Moll, Christian K E
AU - Zittel-Dirks, Simone
AU - Münchau, Alexander
AU - Engel, Andreas K
AU - Hamel, Wolfgang
PY - 2013/1/1
Y1 - 2013/1/1
N2 - Dystonic head tremor (DHT) is characterized by head tremor associated with cervical dystonia (CD). Deep brain stimulation (DBS) can be considered when local treatment with botulinum toxin or oral medication has failed. However, there is lack of data regarding the optimal target structure for surgery in DHT.DBS of the ventrolateral (VL) thalamus is an established treatment option for medically refractory tremor. Tremor suppression is described as being most effective when stimulating at the inferior thalamic base and within the posterior subthalamic area (PSA). Moreover, there is surgical evidence from the pre-DBS era that both lesions and high-frequency stimulation of the PSA improve CD. Based on these observations, we performed DBS in three patients with DHT, placing the proximal contacts of the electrodes into the inferior base of VL thalamic nuclei and the distal contacts into the adjacent PSA. Chronic stimulation improved not only head tremor but also CD. These findings suggest that DBS at the base of VL thalamus and the adjacent PSA should undergo further investigation as a potential target for patients with DHT.
AB - Dystonic head tremor (DHT) is characterized by head tremor associated with cervical dystonia (CD). Deep brain stimulation (DBS) can be considered when local treatment with botulinum toxin or oral medication has failed. However, there is lack of data regarding the optimal target structure for surgery in DHT.DBS of the ventrolateral (VL) thalamus is an established treatment option for medically refractory tremor. Tremor suppression is described as being most effective when stimulating at the inferior thalamic base and within the posterior subthalamic area (PSA). Moreover, there is surgical evidence from the pre-DBS era that both lesions and high-frequency stimulation of the PSA improve CD. Based on these observations, we performed DBS in three patients with DHT, placing the proximal contacts of the electrodes into the inferior base of VL thalamic nuclei and the distal contacts into the adjacent PSA. Chronic stimulation improved not only head tremor but also CD. These findings suggest that DBS at the base of VL thalamus and the adjacent PSA should undergo further investigation as a potential target for patients with DHT.
KW - Adult
KW - Aged
KW - Deep Brain Stimulation
KW - Dystonia
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Subthalamic Nucleus
KW - Tomography, X-Ray Computed
KW - Treatment Outcome
KW - Tremor
KW - Ventral Thalamic Nuclei
U2 - 10.1007/978-3-7091-1482-7_11
DO - 10.1007/978-3-7091-1482-7_11
M3 - SCORING: Journal article
C2 - 23652659
VL - 117
SP - 67
EP - 72
JO - ACTA NEUROCHIR SUPPL
JF - ACTA NEUROCHIR SUPPL
SN - 0065-1419
ER -