Document Detail


Deep brain stimulation of the VIM thalamic nucleus modifies several features of essential tremor.
MedLine Citation:
PMID:  14557560     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pharmacologic interventions (e.g., beta blockers) and thalamic lesions have failed to alter the pathophysiology of essential tremor (ET) beyond a reduction in tremor amplitude. Deep brain stimulation (DBS) of the ventral intermediate (VIM) nucleus of the thalamus successfully reduces tremor rating scores. It is unknown how VIM DBS alters the pathophysiologic characteristics of ET. OBJECTIVE: To determine the effects of VIM DBS on the neurophysiologic characteristics of ET. METHODS: Hand tremor and EMG activity of forearm extensor and flexor muscles were recorded in six patients with ET ON-DBS and OFF-DBS and from six age- and sex-matched control subjects. Hand tremor was assessed across different inertial loads. The amplitude, frequency, regularity, and tremor-EMG coherence were analyzed. RESULTS: VIM DBS reduced the amplitude, increased the frequency, decreased the regularity, and reduced the 1 to 8 Hz tremor-EMG coherence of ET. ON-DBS, patients with ET had greater tremor amplitude, lower frequency, more regularity, and greater tremor-EMG coherence compared to control subjects. CONCLUSIONS: Whereas pharmacologic and thalamic lesions have previously failed to change characteristics of ET beyond amplitude reduction, VIM DBS modified multiple features of ET. The changes in ET after VIM DBS provide strong evidence for clinical efficacy.
Authors:
D E Vaillancourt; M M Sturman; L Verhagen Metman; R A E Bakay; D M Corcos
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Neurology     Volume:  61     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-14     Completed Date:  2004-03-19     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  919-25     Citation Subset:  AIM; IM    
Affiliation:
School of Kinesiology, University of Illinois at Chicago, IL 60608, USA. court1@uic.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Electric Stimulation Therapy / methods*
Electromyography
Essential Tremor / physiopathology*,  therapy*
Female
Forearm
Hand
Humans
Male
Middle Aged
Muscle, Skeletal / physiopathology
Reference Values
Treatment Outcome
Ventral Thalamic Nuclei / physiopathology*
Grant Support
ID/Acronym/Agency:
F32-NS-44727/NS/NINDS NIH HHS; R01-AR-33189/AR/NIAMS NIH HHS; R01-NS-28127/NS/NINDS NIH HHS; R01-NS-40902/NS/NINDS NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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