University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Germany.
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Germany.
Neuroimage Clin. 2020;26:102235. doi: 10.1016/j.nicl.2020.102235. Epub 2020 Mar 4.
To investigate the relation between deep brain stimulation (DBS) of the posterior-subthalamic-area (PSA) and the ventral-intermediate-nucleus (VIM) and the distance to the dentatorubrothalamic tract (DRTT) in essential tremor (ET).
Tremor rating scale (TRS) hemi-scores were analyzed in 13 ET patients, stimulated in both the VIM and the PSA in a randomized, crossover trial. Distances of PSA and VIM contacts to population-based DRTTs were calculated. The relationships between distance to DRTT and stimulation amplitude, as well as DBS efficiency (TRS improvement per amplitude) were investigated.
PSA contacts were closer to the DRTT (p = 0.019) and led to a greater improvement in TRS hemi-scores (p = 0.005) than VIM contacts. Proximity to the DRTT was related to lower amplitudes (p < 0.001) and higher DBS efficiency (p = 0.017).
Differences in tremor outcome and stimulation parameters between contacts in the PSA and the VIM can be explained by their different distance to the DRTT.
研究原发性震颤（ET）患者中深部脑刺激（DBS）的后丘脑下区（PSA）和腹侧中间核（VIM）与齿状核红核束（DRTT）之间的关系。
对 13 名 ET 患者进行了随机交叉试验，在 VIM 和 PSA 两个部位进行刺激，分析震颤评定量表（TRS）的半分评分。计算 PSA 和 VIM 触点与基于人群的 DRTT 的距离。研究了距离 DRTT 与刺激幅度以及 DBS 效率（每幅度改善的 TRS）之间的关系。
PSA 触点更接近 DRTT（p=0.019），并且比 VIM 触点更能显著改善 TRS 半分评分（p=0.005）。与 DRTT 的接近程度与较低的振幅（p<0.001）和更高的 DBS 效率（p=0.017）相关。
PSA 和 VIM 触点之间的震颤结果和刺激参数的差异可以用它们与 DRTT 的不同距离来解释。
