Deep brain stimulation of the ventralis oralis anterior thalamic nucleus is effective for dystonic tremor

Mongardi, Lorenzo; Rispoli, Vittorio; Scerrati, Alba; Capone, J.G.; Vaudano, Anna Elisabetta; Bonis, Pasquale De; Morgante, Francesca; Picillo, Marina; Cavallo, Michele Alessandro; Sensi, Mariachiara

doi:10.1016/j.parkreldis.2020.09.040

Cited by 6 publications

(8 citation statements)

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“…This reflects on the concept that the cerebellum plays a causal role in the generation of sinusoidal dystonic tremor syndromes (Fig. 1) and further opens the question of whether differential targets of DBS (ie, cerebellar relay vs pallidal relay thalamic nuclei) should be tailored according to the specific circuitry involved in tremor generation 49,82 …”

Section: Treatmentmentioning

confidence: 99%

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Milestones in Tremor Research: 10 Years Later

Erro

Fasano

Barone

et al. 2022

Movement Disord Clin Pract

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Major progress has occurred during the last decade in the field of tremor. From the clinical standpoint, a new classification has completely revised the nosology of tremor syndromes and has re‐conceptualized essential tremor as a syndrome rather than a single disease entity, fueling an ongoing enlightened debate. Significant advances have been obtained in terms of instrumental measurement of tremor, remarking on the possibility of developing novel treatment strategies based on tremor characteristics, namely tremor‐phase. Moreover, a better understanding of the pathophysiological mechanisms has further led to the suggestion of refining the classification of tremor syndromes according to their driving underpinnings. Finally, surgical options such as deep brain stimulation and focused ultrasound thalamotomy are now part of the therapeutic portfolio for tremor, but several oral drugs, including long‐chain alcohols, T‐channel blockers, allosteric modulators of potassium channels, and of GABA‐A receptors, are currently being tested and hold promise. This review will discuss the key milestones in tremor research of the last 10 years, with a focus on the most common tremor syndromes, namely essential tremor, dystonic tremor, and Parkinsonian tremor.

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Section: Treatmentmentioning

confidence: 99%

“…1 ) and further opens the question of whether differential targets of DBS (ie, cerebellar relay vs pallidal relay thalamic nuclei) should be tailored according to the specific circuitry involved in tremor generation. 49 , 82 …”

Section: Treatmentmentioning

confidence: 99%

Milestones in Tremor Research: 10 Years Later

Erro

Fasano

Barone

et al. 2022

Movement Disord Clin Pract

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“…20 In a limited number of cases, Vo-deep brain stimulation is also reported to be effective for hand dystonia. 21,22 In this study, three patients experienced recurrence of the dystonic symptoms at 3 months after treatment. In radiofrequency Vo-thalamotomy, recurrence can also develop within 3 months after surgery in about 10% of patients with FHD, which results from insufficient or incorrect ablation over the entire Vo nucleus.…”

Section: Discussionmentioning

confidence: 73%

“… 20 In a limited number of cases, Vo‐deep brain stimulation is also reported to be effective for hand dystonia. 21 , 22 …”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance‐Guided Focused Ultrasound Thalamotomy for Focal Hand Dystonia: A Pilot Study

Horisawa

Yamaguchi²,

Abe

et al. 2021

Movement Disorders

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Background: The efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy for the treatment of focal hand dystonia (FHD) is not well known. Objective: We aimed to prospectively investigate the efficacy of MRgFUS thalamotomy for the treatment of FHD. Methods: We performed MRgFUS thalamotomy of the ventro-oral (Vo) nucleus in 10 patients with FHD. We evaluated the scores of the Writer's Cramp Rating Scale (WCRS, 0-30; higher scores indicating greater severity), Tubiana Musician's Dystonia Scale (TMDS, 0-5; lower scores indicating greater severity), and Arm Dystonia Disability Scale (ADDS, 0%-100%; lower scores indicating greater disability) at baseline and 3 and 12 months post-treatment.Results: WCRS, TMDS, and ADDS scores significantly improved from 6.3 AE 2.7, 1.4 AE 0.5, and 58.7% AE 14.3% at baseline to 1.6 AE 3.1 (P = 0.011), 5.0 AE 0 (P = 0.0001), and 81.6% AE 22.9% (P = 0.0229) at 12 months, respectively. There was one prolonged case of dysarthria at 12 months. Conclusion:We show that MRgFUS Vo-thalamotomy significantly improved FHD.

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“…Essential tremor and parkinsonian tremor respond well to DBS of the ventral intermediate nucleus (Vim) of the thalamus (Cury et al, 2017 ; Dallapiazza et al, 2019 ). Other tremor disorders, such as dystonic tremor, multiple sclerosis tremor, and Holmes' tremor, are treated well with stimulation of the ventral oralis anterior (Voa) and posterior (Vop) nuclei of the thalamus (Katayama et al, 2005 ; Foote et al, 2006 ; Cury et al, 2017 ; Mongardi et al, 2020 ). The Voa/Vop is also chosen as a DBS target when an intraoperative Vim stimulation trial is not satisfactory (Katayama et al, 2005 ; Molnar et al, 2005 ).…”

Section: Introductionmentioning

confidence: 99%