Structure-function relationship of the posterior subthalamic area with directional deep brain stimulation for essential tremor

Abstract

Highlights Directional DBS of the DRTT and the zona incerta is correlated with tremor suppression. Activation patterns for tremor suppression and side effects involve mostly the dentato-rubro-thalamic tract and the zona incerta. Concomitant side effects often limit the therapeutic window of directional deep brain stimulation.

Lateral cerebellothalamic tract activation underlies DBS therapy for Essential Tremor

“…There was also little or no activation of the LF and TF. These subject-specific pathway activation modeling results confirm previous studies based on 3T MRI and volume of tissue activated calculations that found positive association with the CTT region and tremor reduction [ 22 - 25 , 30 , 31 , 68 - 70 ].…”

“…Biophysical modeling of DBS has become an important tool to identify relationships between the volume of tissue activated [ 29 , 30 ] or the predicted pathways activated [ 31 - 33 ] and the resulting clinical efficacy and side effects of each stimulus setting. Recent studies have shown that pathway activation models, which directly simulate multi-compartment axonal membrane dynamics, are significantly more accurate compared to activating function and driving-function based methods [ 34 ].…”

Combining Multimodal Biomarkers to Guide Deep Brain Stimulation Programming in Parkinson Disease

“…As anatomical landmark feature, we set the minimum distance (Euclidean distance) of the contact center to a previously published volume of tissue activated (VTA)-based anatomical reference point (stimulation sweet spot indicating a low effect threshold) within the normalized space of the motor STN (Montreal Neurological Institute x: 12.5838 y: −12.4868 z: −6.2879). 30 Lead reconstruction was performed with the Lead-DBS toolbox 31,32 (details in the Supplementary Material).…”

Deep Brain Stimulation for Tremor: Update on Long-Term Outcomes, Target Considerations and Future Directions

“…The most commonly reported stimulation-related adverse effect was dysarthria (20-57%), followed by spasms (34%) and postural instability (16-29%) of the electrodes implanted in the cZi/PSA. In addition, oculomotor side effects and paresthesias have been described in 19% and 11-14%, respectively [54,59,65,66].…”