Objective: To evaluate the ability of high-field MRI to consistently produce high-resolution, anatomical images of the thalamic ventrointermediate nucleus (Vim) suitable for stereotactic targeting.
Methods: MR images of the thalamus of patients treated for essential tremor were acquired prior to treatment using a 3-tesla MR system. Similar images were acquired in 6 volunteers using, for comparison, both a 1.5-tesla and a 3.0-tesla system.
Results: The thalamic Vim was clearly and consistently delineated on the 3-tesla images. These images were successfully used for target localization in essential tremor patients. In the volunteers data, images acquired using the 1.5-tesla system were inferior to those acquired using the 3-tesla system, lacking the ability to consistently provide reliably defined borders of the Vim.
Conclusion: 3-Tesla MRI can provide high-quality depiction of the Vim, potentially enabling accurate treatment planning by direct visualization and definition of the targeted Vim.
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http://dx.doi.org/10.1159/000092683 | DOI Listing |
Stereotact Funct Neurosurg
October 2024
AMU-CRNS, Centre de recherche en psychologie et neurosciences, Marseille, France.
Introduction: Essential tremor (ET) is the most common movement disorder, characterized by an action tremor in the upper limbs. Neurosurgical techniques targeting the thalamic ventrointermediate nucleus (VIM) including thermocoagulation demonstrated a potential risk for gait and posture worsening. This study evaluates the potential effect of VIM Gamma Knife radiosurgery (GKR) in ET on gait and posture performances.
View Article and Find Full Text PDFOper Neurosurg (Hagerstown)
September 2024
Department of Neurosurgery, NYU Langone Health, New York, New York, USA.
Int Med Case Rep J
July 2024
Liaocheng People's Hospital, Liaocheng, Shandong, People's Republic of China.
We report the case of a 53-year-old man who was diagnosed with Holmes tremor and underwent deep brain stimulation of the ventro-intermediate thalamic nucleus and posterior subthalamic area. We assessed the patients' tremor with the Fahn-Tolosa-Marin Tremor Rating Scale at 1, 3, 6, 12 and 24 months after deep brain stimulation. Deep brain stimulation relieved the patient's tremor during the 24-month follow-up period.
View Article and Find Full Text PDFMov Disord Clin Pract
June 2024
Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel and Christian Albrechts-University of Kiel, Kiel, Germany.
Background: Head tremor is common in dystonia syndromes and difficult to treat. Deep brain stimulation (DBS) is a therapeutic option in medically-refractory cases. In most DBS-centers, the globus pallidus internus (GPi) is targeted in patients with predominant dystonia and the ventrointermediate nucleus of the thalamus (Vim) in predominant tremor.
View Article and Find Full Text PDFOper Neurosurg (Hagerstown)
July 2024
Case Western Reserve University School of Medicine, Cleveland , Ohio , USA.
Background And Objectives: Asleep, image-guided deep brain stimulation (DBS) is a modern alternative to awake, microelectrode recording (MER) guidance. Studies demonstrate comparable efficacy and complications between techniques, although some report lower stimulation thresholds for side effects with image guidance. In addition, few studies directly compare the risk of postoperative transient confusion (pTC) across techniques.
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