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Updated: Feb 25, 2026

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Deep Brain Stimulation for Tremor: Is There a Common Structure?

Michael Fiechter1, Andreas Nowacki, Markus F Oertel

  • 1Department of Neurosurgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.

Stereotactic and Functional Neurosurgery
|August 4, 2017
PubMed
Summary
This summary is machine-generated.

Optimal tremor control in Parkinson disease may involve stimulating the white matter surrounding the subthalamic nucleus (STN) or ventral intermediate nucleus (VIM). This study identified specific stimulation sites within the dentato-rubro-thalamic tract (DRTT) for improved tremor management.

Keywords:
Deep brain stimulationDentato-rubro-thalamic tractSubthalamic nucleusThalamic ventral intermediate nucleusTremor

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Area of Science:

  • Neurosurgery
  • Neurology
  • Movement Disorders

Background:

  • Subthalamic nucleus (STN) and ventral intermediate nucleus (VIM) stimulation effectively manage Parkinson disease tremors.
  • Posterior subthalamic area (PSA) stimulation also shows promise for tremor control.
  • Optimal stimulation sites may be located in white matter tracts adjacent to established targets.

Purpose of the Study:

  • To investigate the precise stimulation areas correlated with maximal tremor reduction in patients undergoing STN or VIM deep brain stimulation.
  • To compare stimulation sites across different studies to identify common effective targets.

Main Methods:

  • Analyzing the stimulation site and volume of tissue activated (VTA) in 25 patients with STN or VIM implants.
  • Projecting patient data onto the Morel atlas for anatomical localization.
  • Comparing findings with stimulation sites reported in other tremor control studies.

Main Results:

  • Patient VTAs consistently covered areas superior/medial to STN or inferior to VIM.
  • Effective stimulation involved the lateral/superior dentato-rubro-thalamic tract (DRTT).
  • Other studies' targets implicated a more medial/inferior DRTT portion within the PSA.

Conclusions:

  • The dentato-rubro-thalamic tract (DRTT) appears to be a key structure for tremor control via stimulation within the PSA/caudal zona incerta.
  • Different portions of the DRTT may be targeted for tremor suppression.
  • Anatomical and diffusion tensor imaging data support the DRTT as a common substrate for effective tremor control stimulation.