Asleep Deep Brain Stimulation of the Nucleus Ventralis Intermedius for Essential Tremor Using Indirect Targeting and Interventional Magnetic Resonance Imaging: Single-Institution Case Series.

Vim thalamus asleep DBS essential tremor interventional MRI

Journal

Movement disorders clinical practice
ISSN: 2330-1619
Titre abrégé: Mov Disord Clin Pract
Pays: United States
ID NLM: 101630279

Informations de publication

Date de publication:
Jul 2020
Historique:
received: 08 01 2020
revised: 15 03 2020
accepted: 30 03 2020
entrez: 7 7 2020
pubmed: 7 7 2020
medline: 7 7 2020
Statut: epublish

Résumé

Literature on asleep deep brain stimulation (DBS) of the ventralis intermedius (Vim) nucleus in essential tremor is relatively sparse. Furthermore, controversy exists as to whether indirect ("consensus" or "atlas-based") targeting of the Vim requires physiologic adjustment for effective clinical outcomes in DBS surgery. The objective of this study was to evaluate the clinical results of asleep Vim DBS using indirect coordinates and real-time interventional magnetic resonance imaging guidance. Retrospective review of a prospectively collected database was performed to identify patients with essential tremor undergoing asleep Vim DBS using interventional magnetic resonance imaging guidance. Stereotactic and clinical outcomes were abstracted and analyzed using descriptive statistics. A total of 12 consecutive patients were identified, all of whom were available for 6-month clinical follow-up. Stereotactic (radial) error was 0.5 ± 0.2 mm on the left and 0.5 ± 0.3 mm on the right. Fahn-Tolosa-Marin tremor scores in the treated limb(s) decreased by 71.2% ± 31.0% ( Asleep Vim DBS using indirect targeting and interventional magnetic resonance imaging-guided placement is safe and effective, with 6-month clinical results similar to those achieved with awake placement. These data support the use of asleep surgery in essential tremor and represent a baseline for comparison with future studies using more advanced targeting techniques.

Sections du résumé

BACKGROUND BACKGROUND
Literature on asleep deep brain stimulation (DBS) of the ventralis intermedius (Vim) nucleus in essential tremor is relatively sparse. Furthermore, controversy exists as to whether indirect ("consensus" or "atlas-based") targeting of the Vim requires physiologic adjustment for effective clinical outcomes in DBS surgery.
OBJECTIVES OBJECTIVE
The objective of this study was to evaluate the clinical results of asleep Vim DBS using indirect coordinates and real-time interventional magnetic resonance imaging guidance.
METHODS METHODS
Retrospective review of a prospectively collected database was performed to identify patients with essential tremor undergoing asleep Vim DBS using interventional magnetic resonance imaging guidance. Stereotactic and clinical outcomes were abstracted and analyzed using descriptive statistics.
RESULTS RESULTS
A total of 12 consecutive patients were identified, all of whom were available for 6-month clinical follow-up. Stereotactic (radial) error was 0.5 ± 0.2 mm on the left and 0.5 ± 0.3 mm on the right. Fahn-Tolosa-Marin tremor scores in the treated limb(s) decreased by 71.2% ± 31.0% (
CONCLUSIONS CONCLUSIONS
Asleep Vim DBS using indirect targeting and interventional magnetic resonance imaging-guided placement is safe and effective, with 6-month clinical results similar to those achieved with awake placement. These data support the use of asleep surgery in essential tremor and represent a baseline for comparison with future studies using more advanced targeting techniques.

Identifiants

pubmed: 32626797
doi: 10.1002/mdc3.12955
pii: MDC312955
pmc: PMC7328410
doi:

Types de publication

Journal Article

Langues

eng

Pagination

521-530

Informations de copyright

© 2020 International Parkinson and Movement Disorder Society.

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Auteurs

Nicholas Gravbrot (N)

Department of Neurosurgery University of Arizona College of Medicine Tucson Arizona USA.

Aaron Burket (A)

Department of Neurosurgery University of Arizona College of Medicine Tucson Arizona USA.

Manojkumar Saranathan (M)

Department of Medical Imaging University of Arizona College of Medicine Tucson Arizona USA.

Willard S Kasoff (WS)

Department of Neurosurgery University of Arizona College of Medicine Tucson Arizona USA.

Classifications MeSH