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Deep Brain Stimulation of the Caudal Zona Incerta: Tremor Control in Relation to the Location of Stimulation Fields
Department of Pharmacologyand Clinical Neuroscience, Section of Neurosurgery, Umeå University, Umeå, Sweden.
Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, Faculty of Science & Engineering. (MINT)
Unit of Functional and Stereotactic Neurosurgery, Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå.
Department of Pharmacology and Clinical Neuroscience, Division of Neurosurgery, Umeå University, Umeå, Sweden.
2016 (English)In: Stereotactic and Functional Neurosurgery, ISSN 1011-6125, E-ISSN 1423-0372, Vol. 94, no 6, 363-370 p.Article in journal (Refereed) Published
Abstract [en]

Background: The caudal zona incerta (cZi) and posterior subthalamic area (PSA) are an emerging deep brain stimulation (DBS) target for essential tremor (ET). Objectives: To evaluate the efficacy of tremor control in relation to the anatomical locations of stimulation fields in 50 patients with ET and DBS of the cZi. Methods: A total of 240 contacts were evaluated separately with monopolar stimulation, and amplitudes were optimized for improvement of tremor and hand function. Stimulation fields, i.e., volumes of neural activation, were simulated for each optimized setting and assembled into probabilistic stimulation maps (PSMs). Results: There were differences in the anatomical distribution of PSMs associated with good versus poor tremor control. The location of PSMs which achieved good and excellent tremor control corresponded well with the PSM for the clinically used settings, and they were located within the superior part of the PSA. Conclusions: PSMs may serve as a useful tool for defining the most efficacious anatomical location of stimulation. The best tremor control in this series of cZi DBS was achieved with stimulation of the superior part of the PSA, which corresponds to the final part of the cerebellothalamic projections before they reach the ventral lateral thalamus.

Place, publisher, year, edition, pages
S. Karger, 2016. Vol. 94, no 6, 363-370 p.
Keyword [en]
Deep brain stimulation, Essential tremor, Zona incerta, Posterior subthalamic area, Probabilistic stimulation maps
National Category
Medical Engineering
Identifiers
URN: urn:nbn:se:liu:diva-133817DOI: 10.1159/000448926ISI: 000393192200002OAI: oai:DiVA.org:liu-133817DiVA: diva2:1063699
Note

Funding agencies: Umea University; Foundation for Clinical Neuroscience at the University Hospital of Umea; Foundation for Clinical Research of the Stockholm County Council; European Unions Seventh Framework Program IMPACT [305814]

Available from: 2017-01-10 Created: 2017-01-10 Last updated: 2017-03-06Bibliographically approved

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