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Bilateral effects of unilateral thalamic deep brain stimulation: A case report
Author(s) -
Kovacs Norbert,
Pal Endre,
Merkli Hajnalka,
Kellenyi Lorant,
Nagy Ferenc,
Janszky Jozsef,
Balas Istvan
Publication year - 2008
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.21788
Subject(s) - deep brain stimulation , subthalamic nucleus , electromyography , essential tremor , thalamus , thalamic stimulator , medicine , stimulation , physical medicine and rehabilitation , movement disorders , postural tremor , psychology , neuroscience , parkinson's disease , disease , pathology
A recent study has proved that unilateral deep brain stimulation (DBS) of the subthalamic nucleus has bilateral effects. However, it is still unclear whether unilateral ventral intermediate thalamic nucleus (Vim) DBS exerts exclusively contralateral or bilateral effects on tremor. Previous studies demonstrated a clinically irrelevant improvement on the nontarget side after thalamic stimulator implantation, which was considered to be solely the result of mechanical effects. We report here the case of a 55‐year‐old woman in whom unilateral thalamic DBS can stop the disabling postural‐kinetic tremor in both hands. Simultaneous surface electromyography (sEMG), accelerometry, and video recordings were obtained to evaluate the underlying mechanism. After the right Vim DBS was turned off, moderate rest tremor appeared in both hands accompanied by bilateral bursts on sEMG. Because right hand tremor cannot simply reflect the mechanical overflow of the left side, the bilateral improvement caused by right Vim DBS is probably due to an active tremor reduction in this particular case. © 2007 Movement Disorder Society