| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the School of Kinesiology (Drs. Vaillancourt and Corcos, and M.M. Sturman), Department of Bioengineering (Dr. Corcos), and Department of Physical Therapy (Dr. Corcos), University of Illinois at Chicago; and Departments of Neurological Sciences (Drs. Verhagen Metman, Bakay, and Corcos) and Neurosurgery (Drs. Verhagen Metman and Bakay), Rush Presbyterian–St. Luke’s Medical Center, Chicago, IL.
Address correspondence and reprint requests to Dr. David E. Vaillancourt, School of Kinesiology (M/C 194), University of Illinois at Chicago, 901 West Roosevelt Road, Chicago, IL 60608; e-mail: court1{at}uic.edu
Background: Pharmacologic interventions (e.g., ß 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.
Received January 13, 2003. Accepted in final form June 16, 2003.
This article has been cited by other articles:
|
|
 |
|
  A. Gironell and J. Kulisevsky Review: Diagnosis and management of essential tremor and dystonic tremor Therapeutic Advances in Neurological Disorders, July 1, 2009; 2(4): 215 - 222. [Abstract] [PDF]
|
|
|
|
 |
|
 A G Shaikh, H A Jinnah, R M Tripp, L M Optican, S Ramat, F A Lenz, and D S Zee Irregularity distinguishes limb tremor in cervical dystonia from essential tremor J. Neurol. Neurosurg. Psychiatry, February 1, 2008; 79(2): 187 - 189. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Herzog, W. Hamel, R. Wenzelburger, M. Potter, M. O. Pinsker, J. Bartussek, A. Morsnowski, F. Steigerwald, G. Deuschl, and J. Volkmann Kinematic analysis of thalamic versus subthalamic neurostimulation in postural and intention tremor Brain, June 1, 2007; 130(6): 1608 - 1625. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Chen, S. E. Hua, M. A. Smith, F. A. Lenz, and R. Shadmehr Effects of Human Cerebellar Thalamus Disruption on Adaptive Control of Reaching Cereb Cortex, October 1, 2006; 16(10): 1462 - 1473. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. F. Molnar, A. Sailer, C. A. Gunraj, D. I. Cunic, A. E. Lang, A. M. Lozano, E. Moro, and R. Chen Changes in cortical excitability with thalamic deep brain stimulation Neurology, June 14, 2005; 64(11): 1913 - 1919. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. M. Sturman, D. E. Vaillancourt, and D. M. Corcos Effects of Aging on the Regularity of Physiological Tremor J Neurophysiol, June 1, 2005; 93(6): 3064 - 3074. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. M. Sturman, D. E. Vaillancourt, L. V. Metman, R. A. E. Bakay, and D. M. Corcos Effects of subthalamic nucleus stimulation and medication on resting and postural tremor in Parkinson's disease Brain, September 1, 2004; 127(9): 2131 - 2143. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
