Document Detail

The subthalamic nucleus and tremor in Parkinson's disease.
MedLine Citation:
PMID:  9827606     Owner:  NLM     Status:  MEDLINE    
The role of the subthalamic nucleus (STN) in the origin of parkinsonian tremor is discussed. Previous studies in monkeys made parkinsonian by MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) administration suggested a direct participation of the STN in the pathophysiology of tremor. We recorded tremor-related activity in the STN in 12 patients with Parkinson's disease (PD) and found that microstimulation of the sensorimotor region of the nucleus, where these neurons are present, stopped the tremor with a very short latency. Long-term treatment by means of bilateral deep-brain stimulation (DBS) in the same 12 patients led to a significant reduction of tremor as well as other cardinal features of PD. This effect was blindly assessed at 3 months after implantation. In another group of seven patients, a unilateral lesion of the STN was performed. Both postural and resting tremor were significantly improved on the limbs contralateral to the lesion side. In three patients, tremor disappeared completely after 12 months of follow up. The electrophysiologic data and therapeutic effect of inactivating the STN strongly indicated that this structure is directly involved in the origin of parkinsonian tremor, as suggested by the MPTP model.
M C Rodriguez; O J Guridi; L Alvarez; K Mewes; R Macias; J Vitek; M R DeLong; J A Obeso
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Movement disorders : official journal of the Movement Disorder Society     Volume:  13 Suppl 3     ISSN:  0885-3185     ISO Abbreviation:  Mov. Disord.     Publication Date:  1998  
Date Detail:
Created Date:  1999-03-22     Completed Date:  1999-03-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8610688     Medline TA:  Mov Disord     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  111-8     Citation Subset:  IM    
Centro de Neurologia y Neurocirugia Funcional, Clinica Quiron, University of La Laguna, Tenerife, Spain.
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MeSH Terms
Electric Stimulation / methods
Middle Aged
Monitoring, Intraoperative
Parkinson Disease / complications*
Postoperative Period
Preoperative Care
Thalamic Nuclei / surgery*
Tremor / etiology*,  therapy*

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