Abstract
A recent study has proved that unilateral deep brain stimulation (DBS) of the subthalamic nucleus has bilateral effects. However, it is still unclear whether unilateral ventral intermediate thalamic nucleus (Vim) DBS exerts exclusively contralateral or bilateral effects on tremor. Previous studies demonstrated a clinically irrelevant improvement on the nontarget side after thalamic stimulator implantation, which was considered to be solely the result of mechanical effects. We report here the case of a 55-year-old woman in whom unilateral thalamic DBS can stop the disabling postural-kinetic tremor in both hands. Simultaneous surface electromyography (sEMG), accelerometry, and video recordings were obtained to evaluate the underlying mechanism. After the right Vim DBS was turned off, moderate rest tremor appeared in both hands accompanied by bilateral bursts on sEMG. Because right hand tremor cannot simply reflect the mechanical overflow of the left side, the bilateral improvement caused by right Vim DBS is probably due to an active tremor reduction in this particular case.
| Original language | English |
|---|---|
| Pages (from-to) | 276-279 |
| Number of pages | 4 |
| Journal | Movement Disorders |
| Volume | 23 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Jan 30 2008 |
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Keywords
- Deep brain stimulation
- Mitochondrial encephalopathy, thalamotomy, tremor, ventral intermediate nucleus
ASJC Scopus subject areas
- Clinical Neurology
- Neuroscience(all)
- Neurology
Cite this
Bilateral effects of unilateral thalamic deep brain stimulation : A case report. / Kovács, N.; Pal, Endre; Merkli, Hajnalka; Kellenyi, Lorant; Nagy, Ferenc; Janszky, J.; Balas, Istvan.
In: Movement Disorders, Vol. 23, No. 2, 30.01.2008, p. 276-279.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Bilateral effects of unilateral thalamic deep brain stimulation
T2 - A case report
AU - Kovács, N.
AU - Pal, Endre
AU - Merkli, Hajnalka
AU - Kellenyi, Lorant
AU - Nagy, Ferenc
AU - Janszky, J.
AU - Balas, Istvan
PY - 2008/1/30
Y1 - 2008/1/30
N2 - A recent study has proved that unilateral deep brain stimulation (DBS) of the subthalamic nucleus has bilateral effects. However, it is still unclear whether unilateral ventral intermediate thalamic nucleus (Vim) DBS exerts exclusively contralateral or bilateral effects on tremor. Previous studies demonstrated a clinically irrelevant improvement on the nontarget side after thalamic stimulator implantation, which was considered to be solely the result of mechanical effects. We report here the case of a 55-year-old woman in whom unilateral thalamic DBS can stop the disabling postural-kinetic tremor in both hands. Simultaneous surface electromyography (sEMG), accelerometry, and video recordings were obtained to evaluate the underlying mechanism. After the right Vim DBS was turned off, moderate rest tremor appeared in both hands accompanied by bilateral bursts on sEMG. Because right hand tremor cannot simply reflect the mechanical overflow of the left side, the bilateral improvement caused by right Vim DBS is probably due to an active tremor reduction in this particular case.
AB - A recent study has proved that unilateral deep brain stimulation (DBS) of the subthalamic nucleus has bilateral effects. However, it is still unclear whether unilateral ventral intermediate thalamic nucleus (Vim) DBS exerts exclusively contralateral or bilateral effects on tremor. Previous studies demonstrated a clinically irrelevant improvement on the nontarget side after thalamic stimulator implantation, which was considered to be solely the result of mechanical effects. We report here the case of a 55-year-old woman in whom unilateral thalamic DBS can stop the disabling postural-kinetic tremor in both hands. Simultaneous surface electromyography (sEMG), accelerometry, and video recordings were obtained to evaluate the underlying mechanism. After the right Vim DBS was turned off, moderate rest tremor appeared in both hands accompanied by bilateral bursts on sEMG. Because right hand tremor cannot simply reflect the mechanical overflow of the left side, the bilateral improvement caused by right Vim DBS is probably due to an active tremor reduction in this particular case.
KW - Deep brain stimulation
KW - Mitochondrial encephalopathy, thalamotomy, tremor, ventral intermediate nucleus
UR - http://www.scopus.com/inward/record.url?scp=39749108704&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=39749108704&partnerID=8YFLogxK
U2 - 10.1002/mds.21788
DO - 10.1002/mds.21788
M3 - Article
C2 - 18004748
AN - SCOPUS:39749108704
VL - 23
SP - 276
EP - 279
JO - Movement Disorders
JF - Movement Disorders
SN - 0885-3185
IS - 2
ER -