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Pallidotomy for Tremor
Author(s) -
Lozano Andres M.,
Lang Anthony E.,
Hutchison William D.
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.870131319
Subject(s) - pallidotomy , globus pallidus , parkinson's disease , essential tremor , medicine , physical medicine and rehabilitation , neuroscience , deep brain stimulation , psychology , basal ganglia , disease , central nervous system
We studied tremor‐related activity in globus pallidus internus (GPi) neurons and the effects of pallidotomy on tremor in patients with Parkinson's disease. By using micro‐electrode recording, we identified GPi neurons with rhythmic firing at the frequency of contralateral tremor. There was a strong correlation between the tremor‐related neuronal activity and limb tremor (r = 0.73). The majority of tremor‐related neurons were located in the ventral one half of the caudal GPi, the area that is the target for pallidotomy. We found that pallidotomy produced striking improvements in off‐period contralateral tremor. These effects were immediate and were maintained for ≥ 2 years. This benefit is obtained despite the progressive nature of the illness and the often reduced dose of medications after surgery.