Central oscillators in a patient with neuropathic tremor: Evidence from intraoperative local field potential recordings
Identifieur interne : 001759 ( Main/Exploration ); précédent : 001758; suivant : 001760Central oscillators in a patient with neuropathic tremor: Evidence from intraoperative local field potential recordings
Auteurs : Daniel Weiss [Allemagne] ; Rathinaswamy B. Govindan [États-Unis] ; Albrecht Rilk [Allemagne] ; Tobias W Chter [Allemagne] ; Sorin Breit [Allemagne] ; Leopold Zizlsperger [Allemagne] ; Thomas Haarmeier [Allemagne] ; Christian Plewnia [Allemagne] ; Rejko Krüger [Allemagne] ; Alireza Gharabaghi [Allemagne]Source :
- Movement Disorders [ 0885-3185 ] ; 2011-02-01.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Aged, Biological Clocks (physiology), Brain (physiopathology), Brain (surgery), Coherence, Deep Brain Stimulation, Deep brain stimulation, Electroencephalography, Electromyography, Female, Field potential, Human, Humans, Intraoperative, Muscle, Skeletal (physiopathology), Nervous system diseases, Neurons (physiology), Neuropathy, Oscillator, Paraproteinemias (complications), Paraproteinemias (physiopathology), Tremor, Tremor (etiology), Tremor (physiopathology), Tremor (therapy), coherence, deep brain stimulation, local field potentials, neuropathy, tremor.
- MESH :
- complications : Paraproteinemias.
- etiology : Tremor.
- physiology : Biological Clocks, Neurons.
- physiopathology : Brain, Muscle, Skeletal, Paraproteinemias, Tremor.
- surgery : Brain.
- therapy : Tremor.
- Aged, Deep Brain Stimulation, Electroencephalography, Electromyography, Female, Humans.
Abstract
Present pathophysiological concepts of neuropathic tremor assume mistimed and defective afferent input resulting in deregulation of cerebello‐thalamo‐cortical motor networks. Here, we provide direct evidence of central tremor processing in a 76‐year‐old female who underwent bilateral deep brain stimulation of the ventral intermedial nucleus of the thalamus (Vim‐DBS) because of neuropathic tremor associated with IgM paraproteinemia. Electrophysiological recordings of EEG and EMG were performed in three perioperative sessions: (1) preoperatively, (2) intraoperatively, and (3) 4 days after surgery in both rest and postural tremor conditions. Tremor‐related synchronization (coherence) between motor cortex (M1) and muscles (M. extensor digitorum, M. flexor digitorum) was assessed, and additional intraoperative local field potential (LFP) recordings from Vim allowed comprehensive coherence mapping in thalamo‐cortico‐muscular networks. Directionality of information flow was determined by directed transfer function (DTF) and phase analyses. Stimulation effects on tremor and corticomuscular coherence were assessed and the patient was followed for 12 months on clinical outcome measures (Tremor Rating Scale, CADET‐Score). Vim‐DBS reduced tremor (59%) and improved motor functionality in daily activities (31%, CADET‐A) after 12 months. Intraoperative recordings demonstrated significant coherence in the tremor frequency (4 Hz) between M1 and contralateral muscle, Vim and ipsilateral M1, Vim and contralateral muscle, but not between Vim and contralateral M1. Information flow was directed from M1 to Vim and bidirectional between M1 and muscle and between Vim and muscle, respectively. Corticomuscular coherence at tremor frequency was completely suppressed by Vim‐DBS. Our case study demonstrates central oscillators underlying neuropathic tremor and implies a strong pathophysiological rationale for Vim‐DBS. © 2010 Movement Disorder Society
Url:
DOI: 10.1002/mds.23374
Affiliations:
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Le document en format XML
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Biological Clocks (physiology)</term>
<term>Brain (physiopathology)</term>
<term>Brain (surgery)</term>
<term>Coherence</term>
<term>Deep Brain Stimulation</term>
<term>Deep brain stimulation</term>
<term>Electroencephalography</term>
<term>Electromyography</term>
<term>Female</term>
<term>Field potential</term>
<term>Human</term>
<term>Humans</term>
<term>Intraoperative</term>
<term>Muscle, Skeletal (physiopathology)</term>
<term>Nervous system diseases</term>
<term>Neurons (physiology)</term>
<term>Neuropathy</term>
<term>Oscillator</term>
<term>Paraproteinemias (complications)</term>
<term>Paraproteinemias (physiopathology)</term>
<term>Tremor</term>
<term>Tremor (etiology)</term>
<term>Tremor (physiopathology)</term>
<term>Tremor (therapy)</term>
<term>coherence</term>
<term>deep brain stimulation</term>
<term>local field potentials</term>
<term>neuropathy</term>
<term>tremor</term>
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<term>Paraproteinemias</term>
<term>Tremor</term>
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<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Brain</term>
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<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Tremor</term>
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<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Deep Brain Stimulation</term>
<term>Electroencephalography</term>
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<term>Female</term>
<term>Humans</term>
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<term>Potentiel champ</term>
<term>Stimulation cérébrale profonde</term>
<term>Tremblement</term>
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<front><div type="abstract" xml:lang="en">Present pathophysiological concepts of neuropathic tremor assume mistimed and defective afferent input resulting in deregulation of cerebello‐thalamo‐cortical motor networks. Here, we provide direct evidence of central tremor processing in a 76‐year‐old female who underwent bilateral deep brain stimulation of the ventral intermedial nucleus of the thalamus (Vim‐DBS) because of neuropathic tremor associated with IgM paraproteinemia. Electrophysiological recordings of EEG and EMG were performed in three perioperative sessions: (1) preoperatively, (2) intraoperatively, and (3) 4 days after surgery in both rest and postural tremor conditions. Tremor‐related synchronization (coherence) between motor cortex (M1) and muscles (M. extensor digitorum, M. flexor digitorum) was assessed, and additional intraoperative local field potential (LFP) recordings from Vim allowed comprehensive coherence mapping in thalamo‐cortico‐muscular networks. Directionality of information flow was determined by directed transfer function (DTF) and phase analyses. Stimulation effects on tremor and corticomuscular coherence were assessed and the patient was followed for 12 months on clinical outcome measures (Tremor Rating Scale, CADET‐Score). Vim‐DBS reduced tremor (59%) and improved motor functionality in daily activities (31%, CADET‐A) after 12 months. Intraoperative recordings demonstrated significant coherence in the tremor frequency (4 Hz) between M1 and contralateral muscle, Vim and ipsilateral M1, Vim and contralateral muscle, but not between Vim and contralateral M1. Information flow was directed from M1 to Vim and bidirectional between M1 and muscle and between Vim and muscle, respectively. Corticomuscular coherence at tremor frequency was completely suppressed by Vim‐DBS. Our case study demonstrates central oscillators underlying neuropathic tremor and implies a strong pathophysiological rationale for Vim‐DBS. © 2010 Movement Disorder Society</div>
</front>
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