Thalamic Deep Brain Stimulation for Writer's Cramp

Cho, Chul Bum; Park, Hae Kwan; Lee, Kyung Jin; Rha, Hyoung Kyun

doi:10.3340/jkns.2009.46.1.52

Cited by 39 publications

(28 citation statements)

References 16 publications

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“…Compared with GPi DBS, STN DBS may offer the advantage of more rapid improvement for dystonia and reduced stimulation parameters [257]. While there is a prior history of thalamotomy for generalized dystonia, thalamic DBS has not been utilized for this indication, perhaps because of the success with GPi and STN DBS, although thalamic DBS (targeting Vim, or the thalamic ventralis oralis nucleus) is being explored for focal forms of dystonia, such as writer's cramp [263][264][265].…”

Section: Use Of Dbs For Dystoniamentioning

confidence: 99%

Deep Brain Stimulation for Movement Disorders of Basal Ganglia Origin: Restoring Function or Functionality?

2016

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Deep brain stimulation (DBS) is highly effective for both hypo-and hyperkinetic movement disorders of basal ganglia origin. The clinical use of DBS is, in part, empiric, based on the experience with prior surgical ablative therapies for these disorders, and, in part, driven by scientific discoveries made decades ago. In this review, we consider anatomical and functional concepts of the basal ganglia relevant to our understanding of DBS mechanisms, as well as our current understanding of the pathophysiology of two of the most commonly DBS-treated conditions, Parkinson's disease and dystonia. Finally, we discuss the proposed mechanism(s) of action of DBS in restoring function in patients with movement disorders. The signs and symptoms of the various disorders appear to result from signature disordered activity in the basal ganglia output, which disrupts the activity in thalamocortical and brainstem networks. The available evidence suggests that the effects of DBS are strongly dependent on targeting sensorimotor portions of specific nodes of the basal gangliathalamocortical motor circuit, that is, the subthalamic nucleus and the internal segment of the globus pallidus. There is little evidence to suggest that DBS in patients with movement disorders restores normal basal ganglia functions (e.g., their role in movement or reinforcement learning). Instead, it appears that high-frequency DBS replaces the abnormal basal ganglia output with a more tolerable pattern, which helps to restore the functionality of downstream networks.

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Section: Use Of Dbs For Dystoniamentioning

confidence: 99%

Deep Brain Stimulation for Movement Disorders of Basal Ganglia Origin: Restoring Function or Functionality?

2016

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“…Since 1969, there have been 11 publications, including this report, in which a total of 31 patients who underwent stereotactic surgery for writer's cramp have been treated (table 1) [15,17,18,19,20,21,22,23,24,25]. They included 21 males and 5 females; the gender of the other 5 was not described.…”

Section: Discussionmentioning

confidence: 99%

“…The mean disease duration in 26 cases was 7.1 years, ranging from 2 to 25 years. Stereotactic surgery included 25 thalamotomies since 1969 [15,17,18,19,20,23,24,25] and 6 DBS since 2007 [21,22]. The target was the Vo in 17 cases, the Vim in 3, both Vo and Vim in 7, and unknown region of thalamus in 4.…”

Section: Discussionmentioning

confidence: 99%

“…The first stereotactic surgery for writer's cramp was reported in 1969 [17]. Since then, the ventral oral nucleus (Vo) [18,19,20,21,22,23] and/or ventral intermediate nucleus (Vim) [21,24] of the thalamus are the common surgical targets. However, there are few reports that systematically report the therapeutic effects of stereotactic surgery on writer's cramp [21,23].…”

Section: Introductionmentioning

confidence: 99%

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Stereotactic Neurosurgery for Writer's Cramp: Report of Two Cases with an Overview of the Literature

Asahi

Koh

Kashiwazaki

et al. 2014

Stereotact Funct Neurosurg

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Background: Writer's cramp is a specific movement disorder with hand muscle cramps in writing, being classified into focal and action-specific dystonia. Stereotactic surgery, such as thalamotomy and deep brain stimulation (DBS), has been reported for writer's cramp; however, the number of reported cases is still scarce and surgical procedures are also controversial. Objectives: In this study, therefore, we present 2 patients who underwent thalamotomy for writer's cramp and systematically review the literature on stereotactic surgery for writer's cramp. Methods: Case reports and literature review are presented. Results: Both patients underwent ventral oral nucleus (Vo) thalamotomy safely. Their symptoms completely disappeared after surgery and did not recur during follow-up periods. In the literature, a total of 31 cases were surgically treated for writer's cramp. Stereotactic surgery included thalamotomy in 25 cases and DBS in 6. The target included the Vo in 17 cases, the ventral intermediate nucleus (Vim) in 3, and both Vo and Vim in 7. Both procedures markedly improved or resolved the symptoms. Transient neurological deficits were observed in 16.0% of patients after thalamotomy. Conclusions: The Vo may be the most effective target to treat writer's cramp. Both thalamotomy and DBS are feasible and effective, but thalamotomy would be a better option, especially in younger or high-risk patients.

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“…For writer's cramp, contralateral unilateral thalamic DBS has been tried with favorable results (Cho et al, 2009;Fukaya et al, 2007). Improvements were immediate in all cases.…”

Section: Task-specific Dystoniasmentioning

confidence: 99%