Anthofer, Judith Maria and Steib, Kathrin and Lange, Max and Rothenfusser, Eva and Fellner, Claudia and Brawanski, Alexander and Schlaier, Juergen (2017) Distance between Active Electrode Contacts and Dentatorubrothalamic Tract in Patients with Habituation of Stimulation Effect of Deep Brain Stimulation in Essential Tremor. JOURNAL OF NEUROLOGICAL SURGERY PART A-CENTRAL EUROPEAN NEUROSURGERY, 78 (4). pp. 350-357. ISSN 2193-6315, 2193-6323
Full text not available from this repository. (Request a copy)Abstract
Background Some patients under thalamic deep brain stimulation (DBS) for essential tremor (ET) experience habituation of tremor reduction. The nucleus ventralis intermedius (Vim) is the current main target side for ET in DBS. However, the dentatorubrothalamic tract (DRTT) is considered the relevant structure to stimulate. We investigated the distance between the active contact of the DBS electrode and the DRTT and compared this distance in patients with habituation of tremor reduction and good responders. Material and Methods In this retrospective study, we performed deterministic fiber tracking of the DRTT in 6 patients (12 hemispheres) with ET who underwent DBS in the Vim. We subsequently measured the distance between the active contact of the electrode and the ipsilateral DRTT in both hemispheres. The clinical tremor response of those 6 patients was analyzed accordingly. Results The distance between the active contact and the DRTT in patients with better and constant clinical tremor reduction was shorter (mean distance: 2.9 +/- 2.2 mm standard deviation [SD]) than in patients who showed habituation of their response (mean distance: 6.1 +/- 3.9 mm SD). After re-placement of a thalamic electrode inside the DRTT in one patient who experienced unsatisfying tremor reduction due to habituation of stimulation, the tremor alleviation was significant and persistent at a 13-month follow-up. Conclusion This retrospective analysis suggests that recurrence of ET tremor under chronic DBS might be associated with a larger distance between the DRTT and the active lead contact, in comparison with the smaller distances in patients with persistently good tremor control.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | DIFFUSION TENSOR TRACTOGRAPHY; NUCLEUS VENTRALIS INTERMEDIUS; RUBRO-THALAMIC TRACT; FIBER TRACKING; SUPPRESSION; ACCURACY; EFFICACY; MRI; essential tremor; dentatoru-brothalamic tract; diffusion tensor imaging; deterministic fiber tracking; deep brain stimulation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurochirurgie Medicine > Lehrstuhl für Neurologie Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 13:16 |
| Last Modified: | 28 Feb 2019 11:13 |
| URI: | https://pred.uni-regensburg.de/id/eprint/1597 |
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