Bilateral effects of unilateral thalamic deep brain stimulation: A case report
Identifieur interne : 002D28 ( Istex/Corpus ); précédent : 002D27; suivant : 002D29Bilateral effects of unilateral thalamic deep brain stimulation: A case report
Auteurs : Norbert Kovacs ; Endre Pal ; Hajnalka Merkli ; Lorant Kellenyi ; Ferenc Nagy ; Jozsef Janszky ; Istvan BalasSource :
- Movement Disorders [ 0885-3185 ] ; 2008-01-30.
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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. © 2007 Movement Disorder Society
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DOI: 10.1002/mds.21788
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ISTEX:424DC365CA379BAC0A9077B126BACE55CBD15988Le document en format XML
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2008-01-30">2008-01-30</date><biblScope unit="vol">23</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="276">276</biblScope><biblScope unit="page" to="279">279</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">424DC365CA379BAC0A9077B126BACE55CBD15988</idno><idno type="DOI">10.1002/mds.21788</idno><idno type="ArticleID">MDS21788</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>deep brain stimulation</term><term>mitochondrial encephalopathy</term><term>thalamotomy</term><term>tremor</term><term>ventral intermediate nucleus</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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. © 2007 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Norbert Kovacs MD</name><affiliations><json:string>Department of Neurology, University of Pecs, Pecs, Hungary</json:string></affiliations></json:item><json:item><name>Endre Pal MD, PhD</name><affiliations><json:string>Department of Neurology, University of Pecs, Pecs, Hungary</json:string></affiliations></json:item><json:item><name>Hajnalka Merkli MD</name><affiliations><json:string>Department of Neurology, University of Pecs, Pecs, Hungary</json:string></affiliations></json:item><json:item><name>Lorant Kellenyi AES</name><affiliations><json:string>Department of Neurology, University of Pecs, Pecs, Hungary</json:string></affiliations></json:item><json:item><name>Ferenc Nagy MD, PhD</name><affiliations><json:string>Department of Neurology, University of Pecs, Pecs, Hungary</json:string></affiliations></json:item><json:item><name>Jozsef Janszky MD, PhD</name><affiliations><json:string>Department of Neurology, University of Pecs, Pecs, Hungary</json:string></affiliations></json:item><json:item><name>Istvan Balas MD, PhD</name><affiliations><json:string>Department of Neurosurgery, University of Pecs, Pecs, Hungary</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>deep brain stimulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>mitochondrial encephalopathy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>thalamotomy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>tremor</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ventral intermediate nucleus</value></json:item></subject><language><json:string>eng</json:string></language><abstract>A recent study has proved that unilateral deep brain stimulation (DBS) of the subthalamic nucleus has bilateral effects. 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<contentMeta> <countGroup> <count type="figureTotal" number="1"></count> <count type="tableTotal" number="0"></count> <count type="referenceTotal" number="11"></count> <count type="wordTotal" number="2021"></count> </countGroup> <titleGroup> <title type="main" xml:lang="en">Bilateral effects of unilateral thalamic deep brain stimulation: A case report</title> <title type="short" xml:lang="en">Bilateral Effects of Unilateral Vim DBS</title> </titleGroup> <creators> <creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"> <personName> <givenNames>Norbert</givenNames> <familyName>Kovacs</familyName> <degrees>MD</degrees> </personName> <contactDetails> <email>norbert.kovacs@aok.pte.hu</email> </contactDetails> </creator> <creator xml:id="au2" creatorRole="author" affiliationRef="#af1"> <personName> <givenNames>Endre</givenNames> <familyName>Pal</familyName> <degrees>MD, PhD</degrees> </personName> </creator> <creator xml:id="au3" creatorRole="author" 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type="organization"> <unparsedAffiliation>Department of Neurology, University of Pecs, Pecs, Hungary</unparsedAffiliation> </affiliation> <affiliation xml:id="af2" countryCode="HU" type="organization"> <unparsedAffiliation>Department of Neurosurgery, University of Pecs, Pecs, Hungary</unparsedAffiliation> </affiliation> </affiliationGroup> <keywordGroup xml:lang="en" type="author"> <keyword xml:id="kwd1">deep brain stimulation</keyword> <keyword xml:id="kwd2">mitochondrial encephalopathy</keyword> <keyword xml:id="kwd3">thalamotomy</keyword> <keyword xml:id="kwd4">tremor</keyword> <keyword xml:id="kwd5">ventral intermediate nucleus</keyword> </keywordGroup> <fundingInfo> <fundingAgency>OTKA T043005 Hungarian State Research Fund</fundingAgency> </fundingInfo> <supportingInformation> <p> This article includes supplementary video clips, available online at <url href="http://www.interscience.wiley.com/jpages/;0885-3185/suppmat"> http://www.interscience.wiley.com/jpages/0885‐3185/suppmat </url> . </p> <supportingInfoItem> <mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds21788:mds21788"></mediaResource> <caption>Segment 1. Right Vim DBS is turned on. Segment 2. Turning off the DBS Segment 3. Right Vim DBS is turned off.</caption> </supportingInfoItem> </supportingInformation> <abstractGroup> <abstract type="main" xml:lang="en"> <title type="main">Abstract</title> <p>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. © 2007 Movement Disorder Society</p> </abstract> </abstractGroup> </contentMeta> </header> </component></istex:document></istex:metadataXml><!--Version 0.6 générée le 3-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Bilateral effects of unilateral thalamic deep brain stimulation: A case report</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Bilateral Effects of Unilateral Vim DBS</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Bilateral effects of unilateral thalamic deep brain stimulation: A case report</title></titleInfo><name type="personal"><namePart type="given">Norbert</namePart><namePart type="family">Kovacs</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University of Pecs, Pecs, Hungary</affiliation><description>Correspondence: Department of Neurology, University of Pecs, H‐7623, Pecs, Ret utca 2, Hungary</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Endre</namePart><namePart type="family">Pal</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, University of Pecs, Pecs, Hungary</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Hajnalka</namePart><namePart type="family">Merkli</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University of Pecs, Pecs, Hungary</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lorant</namePart><namePart type="family">Kellenyi</namePart><namePart type="termsOfAddress">AES</namePart><affiliation>Department of Neurology, University of Pecs, Pecs, Hungary</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ferenc</namePart><namePart type="family">Nagy</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, University of Pecs, Pecs, Hungary</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jozsef</namePart><namePart type="family">Janszky</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, University of Pecs, Pecs, Hungary</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Istvan</namePart><namePart type="family">Balas</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurosurgery, University of Pecs, Pecs, Hungary</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2008-01-30</dateIssued><dateCaptured encoding="w3cdtf">2007-05-12</dateCaptured><dateValid encoding="w3cdtf">2007-09-26</dateValid><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="references">11</extent><extent unit="words">2021</extent></physicalDescription><abstract lang="en">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. © 2007 Movement Disorder Society</abstract><note type="funding">OTKA T043005 Hungarian State Research Fund</note><subject lang="en"><genre>Keywords</genre><topic>deep brain stimulation</topic><topic>mitochondrial encephalopathy</topic><topic>thalamotomy</topic><topic>tremor</topic><topic>ventral intermediate nucleus</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><note type="content"> This article includes supplementary video clips, available online at http://www.interscience.wiley.com/jpages/0885‐3185/suppmat .Supporting Info Item: Segment 1. Right Vim DBS is turned on. Segment 2. Turning off the DBS Segment 3. Right Vim DBS is turned off. - </note><subject><genre>article category</genre><topic>Brief Report</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2008</date><detail type="volume"><caption>vol.</caption><number>23</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>276</start><end>279</end><total>4</total></extent></part></relatedItem><identifier type="istex">424DC365CA379BAC0A9077B126BACE55CBD15988</identifier><identifier type="DOI">10.1002/mds.21788</identifier><identifier type="ArticleID">MDS21788</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2007 Movement Disorder Society</accessCondition><recordInfo><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin><recordContentSource>WILEY</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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