Journal of Neurology

, Volume 252, Supplement 4, pp iv17–iv22 | Cite as

Difference in surgical strategies between thalamotomy and thalamic deep brain stimulation for tremor control

  • Yoichi Katayama
  • Toshikazu Kano
  • Kazutaka Kobayashi
  • Hideki Oshima
  • Chikashi Fukaya
  • Takamitsu Yamamoto

Abstract

Stereotactic targeting strategies differ between thalamotomy and thalamic deep brain stimulation (DBS) for tremor control. In thalamotomy, a minimal radiofrequency lesion created within the lateral portion of the nucleus ventralis intermedius (Vim) often affords the best control of parkinsonian tremor, supporting the assumption that there is a concentrated cluster of cells within this area which is responsible for tremor. However, this assumption may not always be true; such neural elements sometimes appear to spread out across wide areas. Cells with tremor-frequency activity are widely distributed over the areas extending from the Vim to the nuclei ventralis oralis posterior and anterior (Vop and Voa). All of these cells appear to be more or less involved in tremor generation, especially in patients with essential tremor and post-stroke tremor. In contrast to radiofrequency lesions for thalamotomy, electrodes for DBS can be arranged in such a way that wide areas can be stimulated, if necessary. For this purpose, it is critically important to determine optimal placement and orientation of DBS leads for arranging the electrodes to yield maximal benefits in patients with tremor.

Key words

brain stimulation essential  tremor Parkinson’s disease thalamus tremor 

References

  1. 1.
    Albe-Fessard D (1973) Electrophysiological methods for the identification of thalamic nuclei. Z Neurol 205:15–28CrossRefPubMedGoogle Scholar
  2. 2.
    Bates JAV (1969) The significance of tremor phasic units in the human thalamus. In: Gillingham FJ, Donaldson IML (eds) Third Symposium on Parkinson’s Disease, E and S Livingstone, Edinburgh, pp 118–124Google Scholar
  3. 3.
    Benignus VA (1969) Estimation of the coherence spectrum and its confidence interval using the fast fourier transform. IEEE Trans. Audio. Electroacoustic 17:145–150Google Scholar
  4. 4.
    Butler EG, Horne MK, Churchward PR (1992) A frequency analysis of neuronal activity in monkey thalamus, motor cortex and electromyograms in wrist oscillations. J Physiol 445:49–68PubMedGoogle Scholar
  5. 5.
    Buzsaki G, Smith A, Berger S, Fisher LJ, Gage FH (1990) Petit mal epilepsy and parkinsonian tremor: Hypothesis of a common pacemaker. Neuroscience 36:1–14CrossRefPubMedGoogle Scholar
  6. 6.
    Crowell RM, Perret E, Siegfried J, Villoz JP (1968) ‘Movement units’ and ‘tremor phasic units’ in the human thalamus. Brain Res 11:481–488CrossRefPubMedGoogle Scholar
  7. 7.
    Hirai T, Miyazaki M, Nakajima H, Shibazaki T, d Ohye C (1983) The correlation between tremor characteristics and the predicted volume of effective lesions in stereotactic nucleus ventralis intermedius thalamotomy. Brain 106:1001–1018PubMedGoogle Scholar
  8. 8.
    Holsapple JW, Prestone JB, Strick PL (1990) Origin of thalamic input to the ‘hand’ representation in the primary motor cortex (Abstract). Soc Neurosci Abstr 16:425Google Scholar
  9. 9.
    Jasper HH, Bertrand G (1966) Thalamic units involved in somatic sensation and voluntary and involuntary movements in man. In: Purpura DP, Yahr MD (eds) The Thalamus, Columbia University Press, New York, pp 365–390Google Scholar
  10. 10.
    Kobayashi K, Katayama Y, Kasai M, Oshima H, Fukaya C, Yamamoto T (2003) Localization of thalamic cells with tremor-frequency activity in Parkinson’s disease and essential tremor. Acta Neurochir 87(Suppl):137–140Google Scholar
  11. 11.
    Kievit J, Kuypers HGJM (1977) Organization of the thalamo-cortical connections to the frontal lobe in the rhesus monkey. Exp Brain Res 29:299–322CrossRefPubMedGoogle Scholar
  12. 12.
    Lamarre Y, Joffroy AJ (1979) Experimental tremor in monkey: Activity of thalamic and precentral cortical neurons in the absence of peripheral feedback. Adv Neurol 24:109–122Google Scholar
  13. 13.
    Lenz FA, Kwan HC, Dostrovsky JO, Tasker RR, Murphy JT, Lenz YE (1990) Single unit analysis of the human ventral thalamic nuclear group: Activity correlated with movement. Brain 113:1795–1821PubMedGoogle Scholar
  14. 14.
    Lenz FA, Kwan HC, Martin RL, Tasker RR, Dostrovsky JO, Lenz YE (1994) Single unit analysis of the human ventral thalamic nuclear group: Tremor-related activity in functionally identified cells. Brain 117:531–543PubMedGoogle Scholar
  15. 15.
    Lenz FA, Tasker RR, Kwan HC, Schnider S, Kwong R, Murayama Y, Dostrovsky JO, Murphy JT (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 8:754–764PubMedGoogle Scholar
  16. 16.
    Matelli M, Luppino G, Fogassi L, Rizzolatti G (1989) Thalamic input to inferior area 6 and area 4 in the macaque monkey. J Comp Neurol 280:468–488CrossRefPubMedGoogle Scholar
  17. 17.
    Mima T, Hallett M (1999) Corticomuscular coherence: Review. J Clin Neurophysiol 16:501–511CrossRefPubMedGoogle Scholar
  18. 18.
    Mima T, Steger J, Schulman AE, Gerloff C, Hallett M (2000) Electroencephalographic measurement of motor cortex control of muscle activity in humans. Clin Neurophysiol 111:326–337CrossRefPubMedGoogle Scholar
  19. 19.
    Nagaseki Y, Shibasaki T, Hirai T, Kawashima Y, Hirato M, Wada H, Miyazaki M, Ohye C (1986) Long-term follow-up results of selective VIM-thalamotomy. J Neurosurg 65:296–302PubMedGoogle Scholar
  20. 20.
    Ohye C, Albe-Fessard D (1978) Rhythmic discharges related to tremor in humans and monkeys. In: Chalazonitis N, Boisson M (eds) Abnormal neuronal discharges, Raven Press, New York, pp 37–48Google Scholar
  21. 21.
    Ohye C, Narabayashi H (1979) Physiological study of presumed ventralis intermedius neurons in the human thalamus. J Neurosurg 50:290–297PubMedGoogle Scholar
  22. 22.
    Ohye C, Saito Y, Fukamachi A, Narabayashi H (1974) An analysis of the spontaneous rhythmic and nonrhythmic burst discharge in the human thalamus. J Neurol Sci 22:245–259CrossRefPubMedGoogle Scholar
  23. 23.
    Ohye C, Shibazaki T, Hirai T, Wada H, Hirato M, Kawashima Y (1989) Further physiological observations on the ventralis intermedius neurons in the human thalamus. J Neurophysiol 61:488–500PubMedGoogle Scholar
  24. 24.
    Pare D, Curro’Dossi D, Steriade M (1990) Neuronal basis of the parkinsonian resting tremor: A hypothesis and its implication for treatment. Neuroscience 35:217–226CrossRefPubMedGoogle Scholar
  25. 25.
    Raeva S (1986) Localization in human thalamus of units triggered during ‘verbal commands’, voluntary movements and tremor. Electroencephalogr Clin Neurophysiol 63:160–173CrossRefPubMedGoogle Scholar
  26. 26.
    Schell GR, Strick PL (1984) The origin of thalamic input to the arcuate premotor and supplementary motor areas. J Neurosci 4:539–560PubMedGoogle Scholar
  27. 27.
    Strick PL (1976) Anatomical analysis of ventrolateral thalamic input to primate motor cortex. J Neurophysiol 39:1020–1031PubMedGoogle Scholar
  28. 28.
    Strick PL (1976) Activity of ventrolateral thalamic neurons during arm movement. J Neurophysiol 39:1032–1044PubMedGoogle Scholar
  29. 29.
    Tasker RR, Organ LW, Hawrylyshyn PA (1982) The Thalamus and Midbrain of Man: A Physiological Atlas Using Electrical Stimulation, Charles C Thomas, SpringfieldGoogle Scholar
  30. 30.
    Teravainen H, Evarts E, Calne D (1979) Effect of kinesthetic inputs on parkinsonian tremor. Adv Neurol 24:161–173Google Scholar
  31. 31.
    Timmer J, Lauk M, Pfleger W, Deuschl G (1998) Cross-spectral analysis of physiological tremor and muscle activity. I. Theory and application to unsynchronized electromyogram. Biol Cybern 78:349–357CrossRefPubMedGoogle Scholar
  32. 32.
    Velasco F, Molina-Negro P (1973) Electrophysiological topography of the human diencephalons. J Neurosurg 38:204–214PubMedGoogle Scholar
  33. 33.
    Yamamoto T, Katayama Y, Kano T, Kobayashi K, Oshima H, Fukaya C (2004) Deep brain stimulation for the treatment of parkinsonian, essential, and post-stroke tremor. A suitable stimulation method and changes in effective stimulation intensity. J Neurosurg 101:201–209PubMedGoogle Scholar
  34. 34.
    Yamamoto T, Katayama Y, Fukaya C, Oshima H, Kasai M, Kobayashi K (2001) New method of deep brain stimulation therapy using two electrodes implanted in parallel and side by side. J Neurosurg 95:1075–1078PubMedGoogle Scholar

Copyright information

© Steinkopff-Verlag 2005

Authors and Affiliations

  • Yoichi Katayama
    • 1
  • Toshikazu Kano
    • 1
  • Kazutaka Kobayashi
    • 1
  • Hideki Oshima
    • 1
  • Chikashi Fukaya
    • 1
  • Takamitsu Yamamoto
    • 1
  1. 1.Dept. of Neurological Surgery and Division of Applied System NeuroscienceNihon University School of MedicineTokyo 173-8610Japan

Personalised recommendations