Bilateral effects of unilateral thalamic deep brain stimulation: a case report.
Identifieur interne : 001F24 ( Ncbi/Checkpoint ); précédent : 001F23; suivant : 001F25Bilateral effects of unilateral thalamic deep brain stimulation: a case report.
Auteurs : Norbert Kovacs [Hongrie] ; Endre Pal ; Hajnalka Merkli ; Lorant Kellenyi ; Ferenc Nagy ; Jozsef Janszky ; Istvan BalasSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2008.
English descriptors
- KwdEn :
- MESH :
- methods : Deep Brain Stimulation.
- physiology : Thalamus.
- radiation effects : Thalamus.
- therapy : Tremor.
- Female, Humans, Middle Aged.
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.
DOI: 10.1002/mds.21788
PubMed: 18004748
Affiliations:
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<author><name sortKey="Pal, Endre" sort="Pal, Endre" uniqKey="Pal E" first="Endre" last="Pal">Endre Pal</name>
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<author><name sortKey="Merkli, Hajnalka" sort="Merkli, Hajnalka" uniqKey="Merkli H" first="Hajnalka" last="Merkli">Hajnalka Merkli</name>
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<author><name sortKey="Nagy, Ferenc" sort="Nagy, Ferenc" uniqKey="Nagy F" first="Ferenc" last="Nagy">Ferenc Nagy</name>
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<author><name sortKey="Janszky, Jozsef" sort="Janszky, Jozsef" uniqKey="Janszky J" first="Jozsef" last="Janszky">Jozsef Janszky</name>
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<author><name sortKey="Janszky, Jozsef" sort="Janszky, Jozsef" uniqKey="Janszky J" first="Jozsef" last="Janszky">Jozsef Janszky</name>
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<term>Thalamus (physiology)</term>
<term>Thalamus (radiation effects)</term>
<term>Tremor (therapy)</term>
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<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Thalamus</term>
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<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.</div>
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<name sortKey="Janszky, Jozsef" sort="Janszky, Jozsef" uniqKey="Janszky J" first="Jozsef" last="Janszky">Jozsef Janszky</name>
<name sortKey="Kellenyi, Lorant" sort="Kellenyi, Lorant" uniqKey="Kellenyi L" first="Lorant" last="Kellenyi">Lorant Kellenyi</name>
<name sortKey="Merkli, Hajnalka" sort="Merkli, Hajnalka" uniqKey="Merkli H" first="Hajnalka" last="Merkli">Hajnalka Merkli</name>
<name sortKey="Nagy, Ferenc" sort="Nagy, Ferenc" uniqKey="Nagy F" first="Ferenc" last="Nagy">Ferenc Nagy</name>
<name sortKey="Pal, Endre" sort="Pal, Endre" uniqKey="Pal E" first="Endre" last="Pal">Endre Pal</name>
</noCountry>
<country name="Hongrie"><noRegion><name sortKey="Kovacs, Norbert" sort="Kovacs, Norbert" uniqKey="Kovacs N" first="Norbert" last="Kovacs">Norbert Kovacs</name>
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