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Thalamic Deep Brain Stimulation for Parkinson’s Disease and Essential Tremor

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Surgical Treatment of Parkinson’s Disease and Other Movement Disorders

Part of the book series: Current Clinical Neurology ((CCNEU))

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Abstract

Discussion of thalamic surgery for treatment of tremor begins with an understanding of anatomic terminology. Several nomenclatures have been used for the nuclei of the human thalamus (1–4). Hassler’s terminology (1) is the most commonly used in the movement disorders literature and will be used here. The motor thalamus lies ventrally and from front to back consists of lateral polaris (LPo) most anteriorly receiving input from globus pallidus (GPi) and substantia nigra pars reticulata (SNr); ventralis oralis anterior (Voa) and ventralis oralis posterior (Vop) receiving input from GPi; and ventral intermediate nucleus (Vim) receiving input from cerebellum. Ventralis caudalis (Vc) lies posterior to motor thalamus receiving lemniscal and spinothalamic sensory input. In the Anglo-American nomenclature, the ventral anterior nucleus (VA) includes Lpo and Voa, the ventrolateral nucleus (VL) includes Vop and Vim, and the ventral posterior nucleus is equivalent to Vc.

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References

  1. Hassler, R. (1959) Introduction to Stereotaxis with an Atlas of the Human Brain. Thieme, Stuttgart.

    Google Scholar 

  2. Walker, A. E. (1982) Normal and pathological physiology of the human thalamus. In: Stereotaxy of the Human Brain: Anatomical, Physiological, and Clinical Applications (Schaltenbrand, G. and Walker, A. E., eds.), Thieme, Stuttgart, pp. 181–217.

    Google Scholar 

  3. Jones, E. G. (1990) Correlation and revised nomenclature of ventral nuclei in the thalamus of human and monkey. Stereotact. Funct. Neurosurg. 54/55, 1–20.

    Article  PubMed  CAS  Google Scholar 

  4. Hirai, T. and Jones, E. G. (1989) A new parcellation of the human thalamus on the basis of histochemical staining. Brain Res. Rev. 14, 1–34.

    Article  PubMed  CAS  Google Scholar 

  5. Albe-Fessard, D., Arfel, G., and Guiot, G. (1962) Activities electriques characteristiques de quelques structures cerebrales chez l’homme. Ann. Chir. 17, 1185–1214.

    Google Scholar 

  6. Lenz, F. A., Tasker, R. R., Kwan, H. C., et al. (1988) Single unit analysis of the human ventral thalamic nuclear group: correlation of thalamic “tremor cells” with the 3–6 Hz component of parkinsonian tremor. J. Neurosci. 8, 754–764.

    PubMed  CAS  Google Scholar 

  7. Ohye, C. and Narabayashi, H. (1979) Physiological study of presumed ventralis intermedius neurons in the human thalamus. J. Neurosurg. 50, 290–297.

    Article  PubMed  CAS  Google Scholar 

  8. Lenz, F. A., Kwan, H. C., Dostrovsky, J. O., Tasker, R. R., Murphy, J. T., and Lenz, Y. E. (1990) Single unit analysis of the human ventral thalamic nuclear group. Brain 113, 1795–1821.

    Article  PubMed  Google Scholar 

  9. Hutchison, W. D., Lozano, A. M., Tasker, R. R., Lang, A. E., and Dostrovsky, J. O. (1997) Identification and characterization of neurons with tremor-frequency activity in human globus pallidus. Exp. Brain Res. 113, 557–563.

    Article  PubMed  CAS  Google Scholar 

  10. Bergman, N. H., Wichmann, T., Karmon, B., and DeLong, M. R. (1994) The primate subthalamic nucleus: II. Neuronal activity in the MPTP model of parkinsonism. J. Neurophysiol. 72, 507–520.

    PubMed  CAS  Google Scholar 

  11. Kelly, P. J. and Gillingham, F. J. (1980) The long-term results of stereotaxic surgery and L-dopa therapy in patients with Parkinson’s disease. J. Neurosurg. 53, 332–337.

    Article  PubMed  CAS  Google Scholar 

  12. Hallett, M. and Litvan, I. (1999) A task force on surgery for Parkinson’s disease. Evaluation of surgery for Parkinson’s disease. Neurology 53, 1910–1921.

    Article  PubMed  CAS  Google Scholar 

  13. Starr, P. A., Vitak, J. L., and Bakay, R. A. E. (1998) Deep brain stimulation for movement disorders. Neurosurg. Clin. North Am. 9, 381–402.

    CAS  Google Scholar 

  14. Obeso, J. A., Benabid, A. L., and Koller, W. C. (2000) Deep brain stimulation for Parkinson’s disease and tremor. Neurology 55(Suppl. 6), 51–566.

    Google Scholar 

  15. Hassler, R., Riechart, T., Munginer, F., et al. (1960) Physiological observations in stereotaxic operations in extrapyramidal motor disturbances. Brain 83, 337–350.

    Article  PubMed  CAS  Google Scholar 

  16. Ohye, C., Kubota, K., Hooper, H. E., et al. (1964) Ventrolateral and subventrolateral thalamic stimulation. Arch. Neurol. 11, 427–434.

    Article  PubMed  CAS  Google Scholar 

  17. Cooper, I. S., Upton, A. R. M., and Amin, I. (1980) Reversibility of chronic neurologic deficits. Some effects of electrical stimulation of the thalamus and internal capsule in man. Appl. Neurophysiol. 43, 244–258.

    PubMed  CAS  Google Scholar 

  18. Andy, O. J. (1983) Thalamic stimulation for control of movement disorders. Appl. Neurophysiol. 46, 107–111.

    PubMed  CAS  Google Scholar 

  19. Benabid, A. L., Pollak, P., Gervason, C., et al. (1991) Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus. Lancet 337, 403–406.

    Article  PubMed  CAS  Google Scholar 

  20. Benabid, A. L., Pollak, P., Loveau, A., Henry, S., and Rougemont, J. (1987) Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Appl. Neurophysiol. 50,344–346.

    PubMed  CAS  Google Scholar 

  21. Haberler, C., Alesch, F., Mazal, P. R., et al. (2000) No tissue damage by chronic deep brain stimulation in Parkinson’s disease. Ann. Neurol. 48, 372–376.

    Article  PubMed  CAS  Google Scholar 

  22. Benabid, A. L., Pollak, P., Siegneuret, E., Hoffmann, D., Gay, E., and Perret, J. (1993) Chronic VIM thalamic stimulation in Parkinson’s disease, essential tremor, and extrapyramidal dyskinesias. Acta Neurochir. 58(Suppl.), 39–44.

    CAS  Google Scholar 

  23. Benabid, A. L., Benazzouz, A., Hoffmann, D., Limousin, P., Krack, P., and Pollak, P. (1998) Long-term electrical inhibition of deep brain targets in movement disorders. Mov. Disord. 13(Suppl. 3), 119–125.

    Article  PubMed  Google Scholar 

  24. Benazzouz, A. and Hallett, M. (2000) Mechanism of action of deep brain stimulation. Neurology 55(Suppl. 6), S13–516.

    PubMed  CAS  Google Scholar 

  25. Ranck, J. B. (1975) Which elements are excited in electrical stimulation of the mammalian central nervous system: a review. Brain Res. 98, 417–440.

    Article  PubMed  Google Scholar 

  26. Schlag, J. and Villablanca, J. (1967) A quantitative study of temporal and spatial response patterns in a thalamic cell population electrically stimulated. Brain Res. 8, 255–270.

    Article  Google Scholar 

  27. Deiber, M. P., Pollak, P., Passingham, R., et al. (1993) Thalamic stimulation and suppression of parkinsonism tremor. Evidence of cerebellar de-activation using positron emission tomography. Brain 116, 267–279.

    Article  PubMed  Google Scholar 

  28. Ceballos-Baumann, A. O., Boecker, H., Fogel, W., et al. (2001) Thalamic stimulation for essential tremor activates motor and deactivates vestibular cortex. Neurology 56, 1347–1354.

    Article  PubMed  CAS  Google Scholar 

  29. Boecker, H., Wills, A., Ceballos-Baumann, A. O., et al. (1997) Stereotactic thalamotomy in tremor dominant Parkinson’s disease: a H2150 PET study of motor activation. Ann. Neurol. 41, 108–111.

    Article  PubMed  CAS  Google Scholar 

  30. Ashby, P. and Rothwell, J. C. (2000) Neurophysiologic aspects of deep brain stimulation. Neurology 55(Suppl. 6), 517-S20.

    Google Scholar 

  31. Tasker, R. R. (1986) Effets sensitifs et moteurs de la stimulation thalamique chez l’homme. Applications Cliniques. Rev. Neurol. 142, 316–326.

    PubMed  CAS  Google Scholar 

  32. Benabid, A. L., Pollak, P., Gao, D., et al. (1996) Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders. J. Neurosurg. 84, 203–214.

    Article  PubMed  CAS  Google Scholar 

  33. Benabid, A. L., Benazzouz, A., Gao, D., et al. (1999) Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus and of other nuclei as a treatment for Parkinson’s disease. Techn. Neurosurg. 5, 5–30.

    Article  Google Scholar 

  34. Hariz, M. I., Shamsgovara, P., Johansson, F., Hariz, G. M., and Fodstad, H. (1999) Tolerance and tremor rebound fkollowing long-term chronic thalamic stimulation for parkinsonian and essential tremor. Stereotact. Funct. Neurosurg. 72, 208–218.

    Article  PubMed  CAS  Google Scholar 

  35. Alesch, F., Pinter, M. M., Helscher, R. J., Fertl, L., Benabid, A. L., and Koos, W. T. (1995) Stimulation of the ventral intermediate thalamic nucleus in tremor dominated Parkinson’s disease and essential tremor. Acta. Neurochir. 136, 75–81.

    Article  CAS  Google Scholar 

  36. Koller, W., Pahwa, R., Busenbark, K., et al. (1997) High-frequency unilateral thalamic stimulation in the treatment of essential and parkinsonian tremor. Ann. Neurol. 42, 292–299.

    Article  PubMed  CAS  Google Scholar 

  37. Tarsy, D., Ryan, P., Mechanic, D., and Norregaard, T. (1999) Thalamic deep brain stimulation for Parkinson’s and essential tremor. Parkinsonism Rel. Disord. 5(Suppl.), S112.

    Google Scholar 

  38. Blond, S. and Siegfried, J. (1991) Thalamic stimulation for the treatment of tremor and other movement disorders. Acta Neurochirurg. 52(Suppl.), 109–111.

    Article  CAS  Google Scholar 

  39. Blond, S., Caparros-Lefebvre, D., Parker, F., et al. (1992) Control of tremor and involuntary movement disorders by chronic stereotactic stimulation of the ventral intermediate thalamic nucleus. J. Neurosurg. 77, 62–68.

    Article  PubMed  CAS  Google Scholar 

  40. Hubble, J. P., Busenbark, K. L., Wilkinson, S., et al. (1997) Effects of thalamic deep brain stimulation based on tremor type and diagnosis. Mov. Disord. 12, 337–341.

    Article  PubMed  CAS  Google Scholar 

  41. Ondo, W., Jankovic, J., Schwartz, K., et al. (1998) Unilateral thalamic deep brain stimulation for refractory essential tremor and Parkinson’s disease tremor. Neurology 51, 1063–1069.

    Article  PubMed  CAS  Google Scholar 

  42. Limousin, P., Speelman, J. D., Gielen, F., et al. (1999) Multicentre European study of thalamic stimulation in parkinsonian and essential tremor. J. Neurol. Neurosurg. Psychiatry 66, 289–296.

    Article  PubMed  CAS  Google Scholar 

  43. Apetauerova, D., Ryan, P., Mechanic, D., Norregaard, T., and Tarsy, D. (2001) Parkinson’s disease remains stable for two years following thalamic deep brain stimulation for tremor. Mov. Disord. 16, 990–991.

    Google Scholar 

  44. Ondo, W., Almaguer, M., Jankovic, J., and Simpson, R. K. (2001) Thalamic deep brain stimulation. Comparison between unilateral and bilateral placement. Arch. Neurol. 58, 218–222.

    Article  PubMed  CAS  Google Scholar 

  45. Burleigh, A. L., Horak, F. B., Burchiel, J. K., and Nutt, J. G. (1993) Effects of thalamic stimulation on tremor, balance, and step initiation. A single subject study. Mov. Disord. 8, 519–524.

    Article  PubMed  CAS  Google Scholar 

  46. Defebvre, L., Blatt, J. L., Blond, S., et al. (1996) Effect of thalamic stimulation in Parkinson disease. Arch. Neurol. 53, 898–903.

    Article  PubMed  CAS  Google Scholar 

  47. Pinter, M. M., Murg, M., Alesch, F., et al. (1999) Does deep brain stimulation of the nucleus ventralis intermedius affect postural control and locomotion in Parkinson’s disease? Mov. Disord. 6, 958–963.

    Article  Google Scholar 

  48. Caparros-Lefebvre, D., Blond, S., Vermersch, P., et al. (1993) Chronic thalamic stimulation improves tremor and levodopa-induced dyskinesias in Parkinson’s disease. J. Neurol. Neurosurg. Psychiatry 56, 268–273.

    Article  PubMed  CAS  Google Scholar 

  49. Caparros-Lefebvre, D., Blond, S., Feltin, M. P., Pollak, P., and Benabid, A. L. (1999) Improvement of levodopa induced dyskinesias by thalamic deep brain stimulation as related to slight variation in electrode placement: possible involvement of the centre median and parafascicularis complex. J. Neurol. Neurosurg. Psychiatry 67, 308–314.

    Article  PubMed  CAS  Google Scholar 

  50. Troster, A. I., Fields, J. A., Pahwa, R., et al. (1999) Neuropsychological and quality of life outcome after thalamic stimulation for essential tremor. Neuroloy 53, 1174–1780.

    Google Scholar 

  51. Hirai, T., Miyazaki, M., Nakajima, H., et al. (1983) The correlation between tremor characteristics and the predicted volume of effective lesions in stereotaxic nucleus ventralis intermedius thalamotomy. Brain 106, 1001–1018.

    Article  PubMed  Google Scholar 

  52. Stellar, S. and Cooper, I. S. (1968) Mortality and morbidity in cryothalamectomy for parkinsonism. A statistical study of 2,868 consecutive operations. J. Neurosurg. 28, 459–467.

    Article  PubMed  CAS  Google Scholar 

  53. Tasker, R. R. (1998) Deep brain stimulation is preferable to thalamotomy for tremor suppression. Surg. Neurol. 49, 145–154.

    Article  PubMed  CAS  Google Scholar 

  54. Schuurman, P. R., Bosch, D. A., Bossuyt, P. M. N., et al. (2000) A comparison of continuous thalamic stimulation and thalamotomy for suppression of severe tremor. N. Engl. J. Med. 342, 461–468.

    Article  PubMed  CAS  Google Scholar 

  55. Goldman, M. S., Ahlskog, J. E., and Kelly, P. J. (1992) The symptomatic and functional outcome of stereotactic thalamotomy for medically intractable essential tremor. J. Neurosurg. 76, 924–928.

    Article  PubMed  CAS  Google Scholar 

  56. Jankovic, J., Cardoso, F., Grossman, R. G., and Hamilton, W. J. (1995) Outcome after stereotactic thalamotomy for parkinsonian, essential and other types of tremor. Neurosurgery 37, 680–687.

    Article  PubMed  CAS  Google Scholar 

  57. Hubble, J. P., Busenbark, K. L., Wilkinson, S., Penn, R. D., Lyons, K., and Koller, W. C. (1996) Deep brain stimulation for essential tremor. Neurology 46, 1150–1153.

    Article  PubMed  CAS  Google Scholar 

  58. Koller, W. C., Pahwa, R., Lyons, K. E., and Wilkinson, S. B. (2000) Deep brain stimulation of the Vim nucleus of the thalamus for the treatment of tremor. Neurology 55(Suppl. 6), S29-S33.

    PubMed  CAS  Google Scholar 

  59. Pollak, P., Benabid, A. L., Krack, P., et al. (1998) Deep brain stimulation. In: Parkinson’s Disease and Movement Disorders (Jankovic, J. and Tolosa, E, eds.), Williams & Wilkins, Baltimore, MD, pp. 1085–1101.

    Google Scholar 

  60. Pahwa, R., Lyons, K. L., Wilkinson, S. B., et al. (1999) Bilateral thalamic stimulation for the treatment of essential tremor. Neurology 53, 1447–1450.

    Article  PubMed  CAS  Google Scholar 

  61. Ondo, W., Almaguer, M., Jankovic, J., and Simpson, R. K. (2001) Thalamic deep brain stimulation. Comparison between unilateral and bilateral placement. Arch. Neurol. 58, 218–232.

    Article  PubMed  CAS  Google Scholar 

  62. Taha, J. M., Janszen, M. A., and Favre, J. (1999) Thalamic deep brain stimulation for the treatment of head, voice, and bilateral limb tremor. J. Neurosurg. 91, 68–72.

    Article  PubMed  CAS  Google Scholar 

  63. Koller, W. C., Lyons, K. E., Wilkinson, S. B., and Pahwa, R. (1999) Efficacy of unilateral deep brain stimulation of the VIM nucleus of the thalamus for essential head tremor. Mov. Disord. 14, 847–850.

    Article  PubMed  CAS  Google Scholar 

  64. Obwegeser, A. A., Uitti, R. J., Turk, M. F., Strongosky, A. J., and Wharen, R. E. (2000) Thalamic stimulation for the treatment of midline tremors in essential tremor patients. Neurology 54, 2342–2344.

    Article  PubMed  CAS  Google Scholar 

  65. Carpenter, M. A., Pahwa, R., Miyawaki, K. L., Wilkinson, S. B., Seral, J. P., and Koller, W. C. (1998) Reduction in voice tremor under thalamic stimulation. Neurology 50. 796–798.

    Article  PubMed  CAS  Google Scholar 

  66. Pahwa, R., Lyons, K. E., Wilkinson, S. B., et al. (2001) Comparison of thalamotomy to deep brain stimulation of the thalamus in essential tremor. Mov. Disord. 16, 140–143.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Daniel Tarsy
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  2. Thorkild Norregaard
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  3. Jean Hubble
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Editors and Affiliations

  1. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Daniel Tarsy MD

  2. Emory University School of Medicine, Atlanta, GA, USA

    Jerrold L. Vitek MD, PhD

  3. Toronto Western Hospital, Toronto, ON, Canada

    Andres M. Lozano MD, PhD

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Tarsy, D., Norregaard, T., Hubble, J. (2003). Thalamic Deep Brain Stimulation for Parkinson’s Disease and Essential Tremor. In: Tarsy, D., Vitek, J.L., Lozano, A.M. (eds) Surgical Treatment of Parkinson’s Disease and Other Movement Disorders. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-312-5_11

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  • DOI: https://doi.org/10.1007/978-1-59259-312-5_11

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4684-9736-6

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