3,421 results match your criteria Surgical Treatment of Tremor

Ventralis intermedius nucleus anatomical variability assessment by MRI structural connectivity.

Neuroimage 2021 Jun 2;238:118231. Epub 2021 Jun 2.

Wellcome Centre for Human Neuroimaging, 12 Queen Square, London WC1N 3AR, United Kingdom.

The ventralis intermedius nucleus (Vim) is centrally placed in the dentato-thalamo-cortical pathway (DTCp) and is a key surgical target in the treatment of severe medically refractory tremor. It is not visible on conventional MRI sequences; consequently, stereotactic targeting currently relies on atlas-based coordinates. This fails to capture individual anatomical variability, which may lead to poor long-term clinical efficacy. Read More

View Article and Full-Text PDF

The Distribution of Skull Score and Skull Density Ratio in Tremor Patients for MR-Guided Focused Ultrasound Thalamotomy.

Front Neurosci 2021 17;15:612940. Epub 2021 May 17.

Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan.

Objective: Magnetic resonance-guided focused ultrasound (MRgFUS) is a minimum-invasive surgical approach to non-incisionally cause the thermos-coagulation inside the human brain. The skull score (SS) has already been approved as one of the most dominant factors related to a successful MRgFUS treatment. In this study, we first reveal the SS distribution of the tremor patients, and correlate the SS with the image feature from customized skull density ratio (cSDR). Read More

View Article and Full-Text PDF

Machine Learning Will Extend the Clinical Utility of Adaptive Deep Brain Stimulation.

Mov Disord 2021 04;36(4):796-799

Department of Neurology and Neuroscience Unit, Clínica Universidad de Navarra (CUN) and CIMA Universidad de Navarra, Pamplona, Spain.

View Article and Full-Text PDF

Ventralis oralis anterior (Voa) deep brain stimulation plus Gamma Knife thalamotomy in an elderly patient with essential tremor: A case report.

Medicine (Baltimore) 2021 Apr;100(15):e25461

Department of Neuroscience, Graduate School.

Rationale: Deep brain stimulation (DBS) of the ventralis intermedius nucleus (Vim) provides a safe and effective therapy for medically refractory essential tremor (ET). However, DBS may be risky in elderly patients and those with ischemic brain lesions. Gamma Knife radiosurgery (GKS) is a minimally invasive procedure, but bilateral thalamotomy is dangerous. Read More

View Article and Full-Text PDF

Fatigue in hypokinetic, hyperkinetic, and functional movement disorders.

Parkinsonism Relat Disord 2021 May 29;86:114-123. Epub 2021 Mar 29.

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy. Electronic address:

The emerging science of fatigue has soundly endorsed the need for its unified definition, shared terminology and increased recognition in neurological illnesses. Nevertheless, the real impact of fatigue remains under-recognized. Fatigue describes a sense of tiredness, lack of energy or need for increased effort often perceived as overwhelming, pervasive, and disabling. Read More

View Article and Full-Text PDF

Damage to the central nucleus of the thalamus via atypical Holmes tremor: a case report.

J Int Med Res 2021 Apr;49(4):300060521999567

Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, PR China.

Holmes tremor (HT) is a rare symptomatic movement disorder characterized by a combination of resting, postural, and action tremors. HT is usually caused by lesions in the brain stem, thalamus, and cerebellum, and the pathogenesis is believed to be related to the nigrostriatal pathway and/or the cerebello-thalamo-cortical pathway. Many medications have been used to treat HT with various degrees of effectiveness. Read More

View Article and Full-Text PDF

A Review of Robotic and OCT-Aided Systems for Vitreoretinal Surgery.

Adv Ther 2021 05 3;38(5):2114-2129. Epub 2021 Apr 3.

Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.

The introduction of the intraocular vitrectomy instrument by Machemer et al. has led to remarkable advancements in vitreoretinal surgery enabling the limitations of human physiologic capabilities to be reached. To overcome the barriers of perception, tremor, and dexterity, robotic technologies have been investigated with current advancements nearing the feasibility for clinical use. Read More

View Article and Full-Text PDF

The Decline of Deep Brain Stimulation for Obsessive-Compulsive Disorder Following FDA Humanitarian Device Exemption Approval.

Front Surg 2021 12;8:642503. Epub 2021 Mar 12.

Department of Neurosurgery, University of Florida, Gainesville, FL, United States.

In February 2009, the US Food and Drug Administration (FDA) granted Humanitarian Device Exemption (HDE) for deep brain stimulation (DBS) in the anterior limb of the internal capsule (ALIC) for the treatment of severely debilitating, treatment refractory obsessive-compulsive disorder (OCD). Despite its promise as a life altering treatment for patients with otherwise refractory, severely debilitating OCD, the use of DBS for the treatment of OCD has diminished since the FDA HDE endorsement and is now rarely performed even at busy referral centers. We sought to identify factors hindering OCD patients from receiving DBS therapy. Read More

View Article and Full-Text PDF

Current Developments in Cell Replacement Therapy for Parkinson's Disease.

Neuroscience 2021 05 26;463:370-382. Epub 2021 Mar 26.

Department of Neurology, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China. Electronic address:

Parkinson's disease (PD) is characterized by tremor, rigidity, and bradykinesia. PD is caused mainly by depletion of the nigrostriatal pathway. Conventional medications such as levodopa are highly effective in the early stage of PD; however, these medications fail to prevent the underlying neurodegeneration. Read More

View Article and Full-Text PDF

Increased structural connectivity of thalamic stimulation sites to motor cortex relates to tremor suppression.

Neuroimage Clin 2021 13;30:102628. Epub 2021 Mar 13.

Department of Neurosurgery, 300 UCLA Stein Plaza, Suite 562, David Geffen School of Medicine at UCLA (University of California, Los Angeles), Los Angeles, CA, United States. Electronic address:

Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM-DBS) is a highly successful treatment for medication-refractory essential tremor (ET). Clinical outcomes are dependent on accurate targeting. Here, we aim to develop a framework for connectivity-guided DBS targeting by evaluating probabilistic tractography and clinical response at both initial programming (IP) and clinical follow-up (CF). Read More

View Article and Full-Text PDF

Frameless x-ray-based lead re-implantation after partial hardware removal of deep brain stimulation system with preservation of intracerebral trajectories.

Acta Neurochir (Wien) 2021 Jul 23;163(7):1873-1878. Epub 2021 Mar 23.

Department of Neurosurgery, Georg-August-University, Robert-Koch-Straße 40, 37075, Göttingen, Germany.

Background: Deep brain stimulation (DBS) is an established treatment for patients with medical refractory movement disorders with continuously increasing use also in other neurological and psychiatric diseases. Early and late complications can lead to revision surgeries with partial or complete DBS-system removal. In this study, we aimed to report on our experience with a frameless x-ray-based lead re-implantation technique after partial hardware removal or dysfunction of DBS-system, allowing the preservation of intracerebral trajectories. Read More

View Article and Full-Text PDF

Holmes tremor in a monocentric series of resected brainstem cavernomas.

Neurochirurgie 2021 Jul 19;67(4):315-324. Epub 2021 Mar 19.

Department of Neurosurgery, St-Luc Hospital, Université Catholique de Louvain, Brussels, Belgium. Electronic address:

Object: Several scientific papers report clinical symptoms, indications, complications and outcomes of brainstem cavernous malformation (BSCM) surgery without reporting on the occurrence of postoperative Holmes tremor (HT). Our purpose is to report our experience with HT in a monocentric series of resected brainstem cavernomas.

Methods: We reviewed all the BSCM surgical records between 2002 and 2018 at Saint-Luc University Hospital's Department of Neurosurgery, Brussels and selected patients developing HT postoperatively. Read More

View Article and Full-Text PDF

Case Report: Deep Cerebellar Stimulation for Tremor and Dystonia.

Front Neurol 2021 5;12:642904. Epub 2021 Mar 5.

Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan.

The cerebellum plays an important role in the pathogenesis and pathophysiology of movement disorders, including tremor and dystonia. To date, there have been few reports on deep cerebellar stimulation. The patient was a 35-year-old previously healthy man with no history of movement disorders. Read More

View Article and Full-Text PDF

Stereotaxic Intracranial Delivery of Chemicals, Proteins or Viral Vectors to Study Parkinson's Disease.

J Vis Exp 2021 02 18(168). Epub 2021 Feb 18.

Cell Biology and Gene Expression Section, National Institute on Aging, National Institutes of Health.

Parkinson's disease (PD) is a progressive disorder traditionally defined by resting tremor and akinesia, primarily due to loss of dopaminergic neurons in the substantia nigra. Affected brain areas display intraneuronal fibrillar inclusions consisting mainly of alpha-synuclein (asyn) proteins. No animal model thus far has recapitulated all characteristics of this disease. Read More

View Article and Full-Text PDF
February 2021

Combination targeting of subthalamic nucleus and ventral intermediate thalamic nucleus with a single trajectory in deep brain stimulation for tremor-dominant Parkinson's disease.

J Clin Neurosci 2021 Mar 18;85:92-100. Epub 2021 Jan 18.

MedStar Georgetown University Hospital, Department of Neurosurgery, 3800 Reservoir Road NW, 7PHC, Washington, DC 20007, USA.

Deep brain stimulation (DBS) has traditionally been used to target the subthalamic nucleus (STN) or globus pallidus internus (GPi) to treat Parkinson's disease (PD) and the ventral intermediate thalamic nucleus (VIM) to treat essential tremor (ET). Recent case reports have described targeting both the STN and VIM with a single trajectory and electrode to treat patients with tremor-dominant PD, yet outcome data for this procedure remains sparse. Our objective is to determine the safety and efficacy of combination STN-VIM DBS. Read More

View Article and Full-Text PDF

A case of Anti-LGi1 antibody positive autoimmune epilepsy following deep brain stimulator implantation for essential tremor.

J Neuroimmunol 2021 04 30;353:577503. Epub 2021 Jan 30.

Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; University of Queensland, St Lucia, Queensland, Australia. Electronic address:

We describe a 59-year-old male who developed faciobrachial dystonic seizures and serum Anti-LGi1 antibody positivity 5 weeks after subthalamic deep brain stimulation (DBS) implantation for essential tremor. Brain MRI prior to implantation was normal. Electroencephalogram was normal. Read More

View Article and Full-Text PDF

Adoption of focused ultrasound thalamotomy for essential tremor: why so much fuss about FUS?

J Neurol Neurosurg Psychiatry 2021 May 9;92(5):549-554. Epub 2021 Feb 9.

Division of Neurosurgery, Toronto Western Hospital, Toronto, Ontario, Canada.

Background: Focused ultrasound (FUS) was approved as a new treatment modality for essential tremor (ET) in 2016. The goal of this study was to quantify FUS adoption for ET and understand its drivers.

Methods: The adoption of the various surgical options for ET was estimated using three measures: the number of presentations on the various surgical treatments for ET at specialised international meetings, the number of original papers published as identified by literature searches and the number of thalamotomy procedures performed worldwide for ET as provided by device manufacturers' registries. Read More

View Article and Full-Text PDF

Successful Treatment of Auricular Dystonia by Unilateral Pallidothalamic Tractotomy.

Tremor Other Hyperkinet Mov (N Y) 2021 Jan 22;11. Epub 2021 Jan 22.

Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan.

Background: Ear movement disorders are rarely reported. Although some patients may respond to botulinum toxin injections, reports on surgical treatment options remain limited.

Case Report: A 57-year-old woman was diagnosed with auricular dystonia, which was refractory to botulinum toxin injections. Read More

View Article and Full-Text PDF
January 2021

Closed-Loop Deep Brain Stimulation for Essential Tremor Based on Thalamic Local Field Potentials.

Mov Disord 2021 04 6;36(4):863-873. Epub 2021 Feb 6.

MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK.

Background: High-frequency thalamic stimulation is an effective therapy for essential tremor, which mainly affects voluntary movements and/or sustained postures. However, continuous stimulation may deliver unnecessary current to the brain due to the intermittent nature of the tremor.

Objective: We proposed to close the loop of thalamic stimulation by detecting tremor-provoking movement states using local field potentials recorded from the same electrodes implanted for stimulation, so that the stimulation is only delivered when necessary. Read More

View Article and Full-Text PDF

MINARO HD: control and evaluation of a handheld, highly dynamic surgical robot.

Int J Comput Assist Radiol Surg 2021 Mar 23;16(3):467-474. Epub 2021 Jan 23.

Chair of Medical Engineering, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Pauwelsstraße 20, 52074, Aachen, Germany.

Purpose: Current surgical robotic systems are either large serial arms, resulting in higher risks due to their high inertia and no inherent limitations of the working space, or they are bone-mounted, adding substantial additional task steps to the surgical workflow. The robot presented in this paper has a handy and lightweight design and can be easily held by the surgeon. No rigid fixation to the bone or a cart is necessary. Read More

View Article and Full-Text PDF

Focused Ultrasound Thalamotomy for Refractory Essential Tremor: A Japanese Multicenter Single-Arm Study.

Neurosurgery 2021 03;88(4):751-757

Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.

Background: Several feasibility studies and a randomized, controlled, multicenter trial have demonstrated the safety and efficacy of unilateral transcranial magnetic resonance-guided focused ultrasound (FUS) lesioning of the ventral intermediate thalamic nucleus in treating essential tremor.

Objective: To evaluate the safety and efficacy of FUS thalamotomy in a Japanese patient cohort through a prospective, multicenter, single-arm confirmatory trial.

Methods: A total of 35 patients with disabling refractory essential tremor underwent unilateral FUS thalamotomy and were followed up for 12 post-treatment months. Read More

View Article and Full-Text PDF

V180I genetic Creutzfeldt-Jakob disease with cardiac sympathetic nerve denervation masquerading as Parkinson's disease: A case report.

Medicine (Baltimore) 2021 Jan;100(2):e24294

Department of Neurology, Dokkyo Medical University, Japan.

Rationale: Creutzfeldt-Jakob disease (CJD) with a point mutation of valine to isoleucine at codon 180 of the prion protein gene (V180I) is the most frequent form of genetic CJD in Japan. However, peripheral nerve involvement, especially cardiac sympathetic denervation, has not been investigated in cases with V180I genetic CJD.We herein report a genetically confirmed case of V180I genetic CJD presenting with parkinsonism and cardiac sympathetic nerve denervation. Read More

View Article and Full-Text PDF
January 2021

[Deep brain stimulation for Parkinson's disease].

Fortschr Neurol Psychiatr 2021 Jan 19;89(1-02):56-65. Epub 2021 Jan 19.

Deep brain stimulation is an established and evidence-based therapeutic option for the treatment of advanced Parkinson's disease. Main indication and inclusion criteria are the presence of idiopathic Parkinsonism with motor fluctuations and / or dyskinesias and / or with medication refractory tremor, a significant improvement of akinesia / rigidity in response to dopaminergic medication, the absence of relevant cognitive deficits and other significant comorbidities. DBS neurosurgery has a low risk of complications. Read More

View Article and Full-Text PDF
January 2021

Non-invasive suppression of essential tremor via phase-locked disruption of its temporal coherence.

Nat Commun 2021 01 13;12(1):363. Epub 2021 Jan 13.

Department of Brain Sciences, Imperial College London, London, W12 0HS, UK.

Aberrant neural oscillations hallmark numerous brain disorders. Here, we first report a method to track the phase of neural oscillations in real-time via endpoint-corrected Hilbert transform (ecHT) that mitigates the characteristic Gibbs distortion. We then used ecHT to show that the aberrant neural oscillation that hallmarks essential tremor (ET) syndrome, the most common adult movement disorder, can be transiently suppressed via transcranial electrical stimulation of the cerebellum phase-locked to the tremor. Read More

View Article and Full-Text PDF
January 2021

Robotic Liver Surgery - Current Standards and Future Perspectives.

Z Gastroenterol 2021 Jan 11;59(1):56-62. Epub 2021 Jan 11.

Department of General, Visceral and Transplant Surgery, University Hospital Münster, Germany.

Background:  Robotic liver surgery is emerging as the future of minimal invasive surgery. The robotic surgical system offers a stable camera platform, elimination of physiologic tremor, augmented surgical dexterity as well as improved ergonomics because of a seated operating position. Due to the theoretical advantages of the robotic assisted system, complex liver surgery might be an especially interesting indication for a robotic approach since it demands delicate tissue dissection, precise intracorporeal suturing as well as difficult parenchymal transection with subsequent need for meticulous hemostasis and biliostasis. Read More

View Article and Full-Text PDF
January 2021

Long-Term Successful Outcome of Dystonic Head Tremor after Bilateral Deep Brain Stimulation of the Ventral Intermediate and Ventro-Oral Internus Nuclei: A Case Report and Literature Review of Dystonic Head Tremor.

Stereotact Funct Neurosurg 2021 5;99(2):107-112. Epub 2021 Jan 5.

Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan.

Head tremor in patients with dystonia is referred to as dystonic tremor. During surgical treatment, numerous targets may be selected, including the internal segment of the globus pallidus and the ventral intermediate (Vim) nucleus; however, there is no consensus concerning the most effective treatment target. We report herein a case of dystonic head tremor in which improvement persisted for 5 years after deep brain stimulation (DBS) of the bilateral thalamic Vim and ventro-oral internus (Voi) nuclei. Read More

View Article and Full-Text PDF
January 2021

Technological Challenges in the Development of Optogenetic Closed-Loop Therapy Approaches in Epilepsy and Related Network Disorders of the Brain.

Micromachines (Basel) 2020 Dec 31;12(1). Epub 2020 Dec 31.

Center for Microsystems Technology, Imec and Ghent University, 9000 Ghent, Belgium.

Epilepsy is a chronic, neurological disorder affecting millions of people every year. The current available pharmacological and surgical treatments are lacking in overall efficacy and cause side-effects like cognitive impairment, depression, tremor, abnormal liver and kidney function. In recent years, the application of optogenetic implants have shown promise to target aberrant neuronal circuits in epilepsy with the advantage of both high spatial and temporal resolution and high cell-specificity, a feature that could tackle both the efficacy and side-effect problems in epilepsy treatment. Read More

View Article and Full-Text PDF
December 2020

The development of an implantable deep brain stimulation device with simultaneous chronic electrophysiological recording and stimulation in humans.

Biosens Bioelectron 2021 Mar 15;176:112888. Epub 2020 Dec 15.

Mayo Clinic Medical Scientist Training Program, Mayo Clinic, Rochester, MN, 55905, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, 55905, USA. Electronic address:

Deep brain stimulation (DBS) is used to treat a wide array of neurologic conditions. However, traditional programming of stimulation parameters relies upon short term subjective observation of patient symptoms and undesired stimulation effects while in the clinic. To gain a more objective measure of the neuronal activity that contributes to patient symptoms and response to treatment, there is a clear need for a fully-implantable DBS system capable of chronically recording patient-specific electrophysiological biomarker signals over time. Read More

View Article and Full-Text PDF

Predictors of Long-Term Outcome of Subthalamic Stimulation in Parkinson Disease.

Ann Neurol 2021 03 9;89(3):587-597. Epub 2021 Jan 9.

Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France.

Objective: This study was undertaken to identify preoperative predictive factors of long-term motor outcome in a large cohort of consecutive Parkinson disease (PD) patients with bilateral subthalamic nucleus deep brain stimulation (STN-DBS).

Methods: All consecutive PD patients who underwent bilateral STN-DBS at the Grenoble University Hospital (France) from 1993 to 2015 were evaluated before surgery, at 1 year (short-term), and in the long term after surgery. All available demographic variables, neuroimaging data, and clinical characteristics were collected. Read More

View Article and Full-Text PDF