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Analysis of Gene Expression Changes in the Rat Hippocampus After Deep Brain Stimulation of the Anterior Thalamic Nucleus
Published on: March 8, 2015
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Unilateral Thalamic Deep Brain Stimulation for Voice Tremor
Josue M Avecillas-Chasin1, Anujan Poologaindran1, Murray D Morrison2
1Department of Surgery, Division of Neurosurgery, The University of British Columbia, Vancouver, British Columbia, Canada.
Stereotactic and Functional Neurosurgery
|January 10, 2019
Summary
Unilateral thalamic stimulation, particularly from a dominant side, effectively reduces voice tremor (VT). Bilateral stimulation and dominant unilateral stimulation offer comparable benefits for VT management.
Area of Science:
- Neurology
- Neurosurgery
- Speech Pathology
Background:
- Voice tremor (VT) is characterized by involuntary, rhythmic instability in vocalization.
- Deep brain stimulation (DBS) targeting the ventral intermediate nucleus (Vim-DBS) shows potential for managing VT.
- This study explores the efficacy of unilateral Vim-DBS in treating patients with VT.
Purpose of the Study:
- To investigate the effect of unilateral deep brain stimulation (DBS) of the ventral intermediate nucleus (Vim) on voice tremor (VT).
- To test the hypothesis that unilateral thalamic stimulation can effectively reduce VT.
- To identify anatomical correlates of effective VT suppression through stimulation.
Main Methods:
- Seven patients with VT and existing Vim-DBS implants participated.
- Patients underwent randomized phonation tasks under conditions of unilateral left, unilateral right, and bilateral thalamic stimulation, plus a no-stimulation control.
- Outcomes were assessed via blinded perceptual VT ratings and acoustic analysis (f0SD); a dominant stimulation side was defined by >2x greater VT reduction.
Main Results:
- Unilateral stimulation provided benefit in all seven patients.
- Five patients demonstrated a dominant stimulation side, while two showed similar benefits from either side.
- Significant improvements in VT scores and f0SD were observed with dominant unilateral stimulation and bilateral stimulation compared to no stimulation or non-dominant unilateral stimulation.
Conclusions:
- Unilateral dominant-side thalamic stimulation and bilateral thalamic stimulation are equally effective in reducing voice tremor.
- Stimulation of the dominant thalamic side, targeting specific ventral and medial Vim regions, is crucial for effective VT control.
- Nondominant unilateral stimulation alone did not significantly improve VT, highlighting the importance of side dominance in treatment.
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