Deep Brain Stimulation of the Ventral Intermediate Nucleus of the Thalamus in Medically Refractory Orthostatic Tremor : Preliminary Observations
Identifieur interne : 001295 ( PascalFrancis/Checkpoint ); précédent : 001294; suivant : 001296Deep Brain Stimulation of the Ventral Intermediate Nucleus of the Thalamus in Medically Refractory Orthostatic Tremor : Preliminary Observations
Auteurs : Alberto J. Espay [États-Unis] ; Andrew P. Duker [États-Unis] ; Robert Chen [Canada] ; Michael S. Okun [États-Unis] ; Edwin T. Barrett [États-Unis] ; Johnna Devoto [États-Unis] ; Pamela Zeilman [États-Unis] ; Maureen Gartner [États-Unis] ; Noël Burton [États-Unis] ; Helard A. Miranda [États-Unis] ; George T. Mandybur [États-Unis] ; Theresa A. Zesiewicz [États-Unis] ; Kelly D. Foote [États-Unis] ; Fredy J. Revilla [États-Unis]Source :
- Movement disorders [ 0885-3185 ] ; 2008.
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Abstract
Orthostatic tremor (OT) is a disabling movement disorder associated with postural and gait impairment in the elderly. Medical therapy often yields insufficient benefit. We report the clinical and electrophysiological data on two patients with medication-refractory OT treated with deep brain stimulation of the ventral intermediate thalamic nucleus (Vim DBS). Patient 1 underwent bilateral deep brain stimulation (DBS) and Patient 2 unilateral Vim DBS following 28 and 30 years of disease duration, respectively. Both patients showed increased latency to symptom onset after rising from a seated position, improved tolerance for prolonged standing, and slower crescendo of tremor severity when remaining upright. Postoperative evaluation demonstrated decreased amplitude of electromyographic activity with persistence of well-defined oscillatory behavior showing strong coherence at 15 Hz between all muscles tested in the upper and lower limbs. Postural sway was unchanged. Clinical benefits have been sustained for over 18 months in Patient 1, and receded after 3 months in Patient 2. These findings support the consideration of bilateral Vim DBS implantation as a therapeutic option in patients with medically refractory OT. Further efficacy studies on chronic stimulation to disrupt the abnormal oscillatory activity in this disorder are warranted.
Affiliations:
- Canada, États-Unis
- Floride, Ohio, Ontario
- Tampa, Toronto
- Université de Floride du Sud, Université de Toronto
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Deep Brain Stimulation of the Ventral Intermediate Nucleus of the Thalamus in Medically Refractory Orthostatic Tremor : Preliminary Observations</title><author><name sortKey="Espay, Alberto J" sort="Espay, Alberto J" uniqKey="Espay A" first="Alberto J." last="Espay">Alberto J. Espay</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Duker, Andrew P" sort="Duker, Andrew P" uniqKey="Duker A" first="Andrew P." last="Duker">Andrew P. Duker</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Chen, Robert" sort="Chen, Robert" uniqKey="Chen R" first="Robert" last="Chen">Robert Chen</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Toronto Western Research Institute, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S." last="Okun">Michael S. Okun</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Department of Neurology, McKnight Brain Institute, Movement Disorders Center, University of Florida College of Medicine</s1><s2>Gainesville, Florida</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Barrett, Edwin T" sort="Barrett, Edwin T" uniqKey="Barrett E" first="Edwin T." last="Barrett">Edwin T. Barrett</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Devoto, Johnna" sort="Devoto, Johnna" uniqKey="Devoto J" first="Johnna" last="Devoto">Johnna Devoto</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Zeilman, Pamela" sort="Zeilman, Pamela" uniqKey="Zeilman P" first="Pamela" last="Zeilman">Pamela Zeilman</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Department of Neurology, McKnight Brain Institute, Movement Disorders Center, University of Florida College of Medicine</s1><s2>Gainesville, Florida</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Gartner, Maureen" sort="Gartner, Maureen" uniqKey="Gartner M" first="Maureen" last="Gartner">Maureen Gartner</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Burton, Noel" sort="Burton, Noel" uniqKey="Burton N" first="Noël" last="Burton">Noël Burton</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Miranda, Helard A" sort="Miranda, Helard A" uniqKey="Miranda H" first="Helard A." last="Miranda">Helard A. Miranda</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Mandybur, George T" sort="Mandybur, George T" uniqKey="Mandybur G" first="George T." last="Mandybur">George T. Mandybur</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Zesiewicz, Theresa A" sort="Zesiewicz, Theresa A" uniqKey="Zesiewicz T" first="Theresa A." last="Zesiewicz">Theresa A. Zesiewicz</name><affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Department of Neurology, University of South Florida</s1><s2>Tampa, Florida</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region><settlement type="city">Tampa</settlement></placeName><orgName type="university">Université de Floride du Sud</orgName></affiliation></author><author><name sortKey="Foote, Kelly D" sort="Foote, Kelly D" uniqKey="Foote K" first="Kelly D." last="Foote">Kelly D. Foote</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Department of Neurology, McKnight Brain Institute, Movement Disorders Center, University of Florida College of Medicine</s1><s2>Gainesville, Florida</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Revilla, Fredy J" sort="Revilla, Fredy J" uniqKey="Revilla F" first="Fredy J." last="Revilla">Fredy J. Revilla</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0058900</idno><date when="2008">2008</date><idno type="stanalyst">PASCAL 09-0058900 INIST</idno><idno type="RBID">Pascal:09-0058900</idno><idno type="wicri:Area/PascalFrancis/Corpus">001035</idno><idno type="wicri:Area/PascalFrancis/Curation">001C84</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">001295</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Deep Brain Stimulation of the Ventral Intermediate Nucleus of the Thalamus in Medically Refractory Orthostatic Tremor : Preliminary Observations</title><author><name sortKey="Espay, Alberto J" sort="Espay, Alberto J" uniqKey="Espay A" first="Alberto J." last="Espay">Alberto J. Espay</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Duker, Andrew P" sort="Duker, Andrew P" uniqKey="Duker A" first="Andrew P." last="Duker">Andrew P. Duker</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Chen, Robert" sort="Chen, Robert" uniqKey="Chen R" first="Robert" last="Chen">Robert Chen</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Toronto Western Research Institute, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S." last="Okun">Michael S. Okun</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Department of Neurology, McKnight Brain Institute, Movement Disorders Center, University of Florida College of Medicine</s1><s2>Gainesville, Florida</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Barrett, Edwin T" sort="Barrett, Edwin T" uniqKey="Barrett E" first="Edwin T." last="Barrett">Edwin T. Barrett</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Devoto, Johnna" sort="Devoto, Johnna" uniqKey="Devoto J" first="Johnna" last="Devoto">Johnna Devoto</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Zeilman, Pamela" sort="Zeilman, Pamela" uniqKey="Zeilman P" first="Pamela" last="Zeilman">Pamela Zeilman</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Department of Neurology, McKnight Brain Institute, Movement Disorders Center, University of Florida College of Medicine</s1><s2>Gainesville, Florida</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Gartner, Maureen" sort="Gartner, Maureen" uniqKey="Gartner M" first="Maureen" last="Gartner">Maureen Gartner</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Burton, Noel" sort="Burton, Noel" uniqKey="Burton N" first="Noël" last="Burton">Noël Burton</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Miranda, Helard A" sort="Miranda, Helard A" uniqKey="Miranda H" first="Helard A." last="Miranda">Helard A. Miranda</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Mandybur, George T" sort="Mandybur, George T" uniqKey="Mandybur G" first="George T." last="Mandybur">George T. Mandybur</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Zesiewicz, Theresa A" sort="Zesiewicz, Theresa A" uniqKey="Zesiewicz T" first="Theresa A." last="Zesiewicz">Theresa A. Zesiewicz</name><affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Department of Neurology, University of South Florida</s1><s2>Tampa, Florida</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region><settlement type="city">Tampa</settlement></placeName><orgName type="university">Université de Floride du Sud</orgName></affiliation></author><author><name sortKey="Foote, Kelly D" sort="Foote, Kelly D" uniqKey="Foote K" first="Kelly D." last="Foote">Kelly D. Foote</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Department of Neurology, McKnight Brain Institute, Movement Disorders Center, University of Florida College of Medicine</s1><s2>Gainesville, Florida</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Floride</region></placeName></affiliation></author><author><name sortKey="Revilla, Fredy J" sort="Revilla, Fredy J" uniqKey="Revilla F" first="Fredy J." last="Revilla">Fredy J. Revilla</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Deep brain stimulation</term><term>Nervous system diseases</term><term>Refractory</term><term>Thalamus</term><term>Tremor</term><term>Ventral nucleus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Tremblement</term><term>Pathologie du système nerveux</term><term>Noyau ventral</term><term>Thalamus</term><term>Réfractaire</term><term>Stimulation cérébrale profonde</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Orthostatic tremor (OT) is a disabling movement disorder associated with postural and gait impairment in the elderly. Medical therapy often yields insufficient benefit. We report the clinical and electrophysiological data on two patients with medication-refractory OT treated with deep brain stimulation of the ventral intermediate thalamic nucleus (Vim DBS). Patient 1 underwent bilateral deep brain stimulation (DBS) and Patient 2 unilateral Vim DBS following 28 and 30 years of disease duration, respectively. Both patients showed increased latency to symptom onset after rising from a seated position, improved tolerance for prolonged standing, and slower crescendo of tremor severity when remaining upright. Postoperative evaluation demonstrated decreased amplitude of electromyographic activity with persistence of well-defined oscillatory behavior showing strong coherence at 15 Hz between all muscles tested in the upper and lower limbs. Postural sway was unchanged. Clinical benefits have been sustained for over 18 months in Patient 1, and receded after 3 months in Patient 2. These findings support the consideration of bilateral Vim DBS implantation as a therapeutic option in patients with medically refractory OT. Further efficacy studies on chronic stimulation to disrupt the abnormal oscillatory activity in this disorder are warranted.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>23</s2></fA05><fA06><s2>16</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Deep Brain Stimulation of the Ventral Intermediate Nucleus of the Thalamus in Medically Refractory Orthostatic Tremor : Preliminary Observations</s1></fA08><fA11 i1="01" i2="1"><s1>ESPAY (Alberto J.)</s1></fA11><fA11 i1="02" i2="1"><s1>DUKER (Andrew P.)</s1></fA11><fA11 i1="03" i2="1"><s1>CHEN (Robert)</s1></fA11><fA11 i1="04" i2="1"><s1>OKUN (Michael S.)</s1></fA11><fA11 i1="05" i2="1"><s1>BARRETT (Edwin T.)</s1></fA11><fA11 i1="06" i2="1"><s1>DEVOTO (Johnna)</s1></fA11><fA11 i1="07" i2="1"><s1>ZEILMAN (Pamela)</s1></fA11><fA11 i1="08" i2="1"><s1>GARTNER (Maureen)</s1></fA11><fA11 i1="09" i2="1"><s1>BURTON (Noël)</s1></fA11><fA11 i1="10" i2="1"><s1>MIRANDA (Helard A.)</s1></fA11><fA11 i1="11" i2="1"><s1>MANDYBUR (George T.)</s1></fA11><fA11 i1="12" i2="1"><s1>ZESIEWICZ (Theresa A.)</s1></fA11><fA11 i1="13" i2="1"><s1>FOOTE (Kelly D.)</s1></fA11><fA11 i1="14" i2="1"><s1>REVILLA (Fredy J.)</s1></fA11><fA14 i1="01"><s1>Department of Neurology, The Neuroscience Institute, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>14 aut.</sZ></fA14><fA14 i1="02"><s1>Toronto Western Research Institute, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ></fA14><fA14 i1="03"><s1>Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ></fA14><fA14 i1="04"><s1>Department of Neurology, McKnight Brain Institute, Movement Disorders Center, University of Florida College of Medicine</s1><s2>Gainesville, Florida</s2><s3>USA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>13 aut.</sZ></fA14><fA14 i1="05"><s1>Department of Neurology, University of South Florida</s1><s2>Tampa, Florida</s2><s3>USA</s3><sZ>12 aut.</sZ></fA14><fA20><s1>2357-2362</s1></fA20><fA21><s1>2008</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000196116650100</s5></fA43><fA44><s0>0000</s0><s1>© 2009 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>13 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>09-0058900</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Orthostatic tremor (OT) is a disabling movement disorder associated with postural and gait impairment in the elderly. Medical therapy often yields insufficient benefit. We report the clinical and electrophysiological data on two patients with medication-refractory OT treated with deep brain stimulation of the ventral intermediate thalamic nucleus (Vim DBS). Patient 1 underwent bilateral deep brain stimulation (DBS) and Patient 2 unilateral Vim DBS following 28 and 30 years of disease duration, respectively. Both patients showed increased latency to symptom onset after rising from a seated position, improved tolerance for prolonged standing, and slower crescendo of tremor severity when remaining upright. Postoperative evaluation demonstrated decreased amplitude of electromyographic activity with persistence of well-defined oscillatory behavior showing strong coherence at 15 Hz between all muscles tested in the upper and lower limbs. Postural sway was unchanged. Clinical benefits have been sustained for over 18 months in Patient 1, and receded after 3 months in Patient 2. These findings support the consideration of bilateral Vim DBS implantation as a therapeutic option in patients with medically refractory OT. Further efficacy studies on chronic stimulation to disrupt the abnormal oscillatory activity in this disorder are warranted.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17A01</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Tremblement</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Tremor</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Temblor</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Noyau ventral</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Ventral nucleus</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Núcleo ventral</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Thalamus</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Thalamus</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Tálamo</s0><s5>10</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Réfractaire</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Refractory</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Refractario</s0><s5>11</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Stimulation cérébrale profonde</s0><s4>CD</s4><s5>96</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Deep brain stimulation</s0><s4>CD</s4><s5>96</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Encéphale</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Encephalon</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Encéfalo</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Système nerveux central</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Central nervous system</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Sistema nervioso central</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Mouvement involontaire</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Involuntary movement</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Movimiento involuntario</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Trouble neurologique</s0><s5>41</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Neurological disorder</s0><s5>41</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Trastorno neurológico</s0><s5>41</s5></fC07><fN21><s1>040</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Floride</li><li>Ohio</li><li>Ontario</li></region><settlement><li>Tampa</li><li>Toronto</li></settlement><orgName><li>Université de Floride du Sud</li><li>Université de Toronto</li></orgName></list><tree><country name="États-Unis"><region name="Ohio"><name sortKey="Espay, Alberto J" sort="Espay, Alberto J" uniqKey="Espay A" first="Alberto J." last="Espay">Alberto J. Espay</name></region><name sortKey="Barrett, Edwin T" sort="Barrett, Edwin T" uniqKey="Barrett E" first="Edwin T." last="Barrett">Edwin T. Barrett</name><name sortKey="Burton, Noel" sort="Burton, Noel" uniqKey="Burton N" first="Noël" last="Burton">Noël Burton</name><name sortKey="Devoto, Johnna" sort="Devoto, Johnna" uniqKey="Devoto J" first="Johnna" last="Devoto">Johnna Devoto</name><name sortKey="Duker, Andrew P" sort="Duker, Andrew P" uniqKey="Duker A" first="Andrew P." last="Duker">Andrew P. Duker</name><name sortKey="Foote, Kelly D" sort="Foote, Kelly D" uniqKey="Foote K" first="Kelly D." last="Foote">Kelly D. Foote</name><name sortKey="Gartner, Maureen" sort="Gartner, Maureen" uniqKey="Gartner M" first="Maureen" last="Gartner">Maureen Gartner</name><name sortKey="Mandybur, George T" sort="Mandybur, George T" uniqKey="Mandybur G" first="George T." last="Mandybur">George T. Mandybur</name><name sortKey="Miranda, Helard A" sort="Miranda, Helard A" uniqKey="Miranda H" first="Helard A." last="Miranda">Helard A. Miranda</name><name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S." last="Okun">Michael S. Okun</name><name sortKey="Revilla, Fredy J" sort="Revilla, Fredy J" uniqKey="Revilla F" first="Fredy J." last="Revilla">Fredy J. Revilla</name><name sortKey="Zeilman, Pamela" sort="Zeilman, Pamela" uniqKey="Zeilman P" first="Pamela" last="Zeilman">Pamela Zeilman</name><name sortKey="Zesiewicz, Theresa A" sort="Zesiewicz, Theresa A" uniqKey="Zesiewicz T" first="Theresa A." last="Zesiewicz">Theresa A. Zesiewicz</name></country><country name="Canada"><noRegion><name sortKey="Chen, Robert" sort="Chen, Robert" uniqKey="Chen R" first="Robert" last="Chen">Robert Chen</name></noRegion><name sortKey="Chen, Robert" sort="Chen, Robert" uniqKey="Chen R" first="Robert" last="Chen">Robert Chen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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