OBJECTIVE: To report on neuroradiological, neurophysiological targeting and long-term efficacy of thalamic Ventral-Oralis complex and Zona Incerta deep brain stimulation in Midline Tremor.
METHODS: Three patients (two males and one female) with Midline Tremor in dystonic syndromes were recruited for this open-label study. Clinical, surgical, neurophysiological intraoperative testing and long-term follow-up data are reported.
RESULTS: Intraoperative testing and reconstruction of volume of tissue activated confirmed the position of the electrodes in the area stimulated between the thalamic Ventral-Oralis complex and Zona Incerta in all patients. All three patients showed optimal control of both tremor and dystonic features at short-term (6 months) and long-term follow-up (up to 6 years). No adverse events occurred.
CONCLUSIONS: In the syndromes of Midline Tremor of various origins, the best target for DBS might be difficult to identify. Our results showed that thalamic Ventral-Oralis complex/Zona Incerta may be a viable and safe option even in specific forms of tremor with axial distribution.
目的:报告神经放射学,丘脑腹口复合体和ZonaIncerta深部脑刺激在中线震颤中的神经生理学靶向和长期疗效。
方法:招募了3名患有肌张力障碍综合征中线震颤的患者(2名男性和1名女性)进行这项开放标签研究。临床,外科,报告了神经生理学术中检测和长期随访数据.
结果:术中测试和激活的组织体积的重建证实了所有患者在丘脑腹侧-口腔复合体和ZonaIncerta之间刺激的区域中电极的位置。在短期(6个月)和长期随访(长达6年)中,所有三名患者均表现出对震颤和肌张力障碍特征的最佳控制。无不良事件发生。
结论:在各种起源的中线震颤综合征中,DBS的最佳目标可能很难确定。我们的结果表明,即使在具有轴向分布的特定形式的震颤中,丘脑腹侧-Oralis复合体/ZonaIncerta也可能是可行且安全的选择。