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Acta Neurochirurgica

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01-12-2011 | Clinical Article

Deep brain stimulation of the subthalamic nucleus versus the zona incerta in the treatment of essential tremor

Authors: Patric Blomstedt, Ulrika Sandvik, Jan Linder, Anna Fredricks, Lars Forsgren, Marwan I. Hariz

Published in: Acta Neurochirurgica | Issue 12/2011

Abstract

Background

Deep brain stimulation (DBS) is an effective treatment for essential tremor (ET). Currently the ventrolateral thalamus is the target of choice, but the posterior subthalamic area (PSA), including the caudal zona incerta (cZi), has demonstrated promising results, and the subthalamic nucleus (STN) has been suggested as a third alternative. The objective of the current study was to evaluate the effect of STN DBS in ET and to compare this to cZi DBS.

Methods

Four patients with ET were implanted with two ipsilateral electrodes, one in the STN and one in the cZi. All contacts were evaluated concerning the acute effect on tremor, and the effect of chronic DBS in either target was analyzed.

Results

STN and cZi both proved to be potent targets for DBS in ET. DBS in the cZi was more efficient, since the same degree of tremor reduction could here be achieved at lower energy consumption. Three patients became tremor-free in the treated hand with either STN or cZi DBS, while the fourth had a minor residual tremor after stimulation in either target.

Conclusion

In this limited material, STN DBS was demonstrated to be an efficient treatment for ET, even though cZi DBS was more efficient. The STN may be an alternative target in the treatment of ET, pending further investigations to decide on the relative merits of the different targets.

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Title: Deep brain stimulation of the subthalamic nucleus versus the zona incerta in the treatment of essential tremor
Authors: Patric Blomstedt
Ulrika Sandvik
Jan Linder
Anna Fredricks
Lars Forsgren
Marwan I. Hariz
Publication date: 01-12-2011
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 12/2011
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-011-1157-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Deep brain stimulation of the subthalamic nucleus versus the zona incerta in the treatment of essential tremor

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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