Treating essential tremor (ET) with deep brain stimulation
A common movement disorder called essential tremor (ET) but its exact mechanisms remain unclear although multiple cortical and subcortical areas have been implicated.
Significant tremor suppression in ET patients was observed with deep brain stimulation (DBS) of the ventralis intermediate nucleus (VIM) of the thalamus and/or the posterior subthalamic area (PSA) but significant inter-patient variability was also seen.
By recording neural activity from the motor cortex and thalamus, along with hand tremor signals, in people with essential tremor, the researchers obtained new insights into the cortico-thalamic network involved in tremor generation.
The authors found a greater clinical effect with DBS in those with stronger cortico-thalamo-tremor connectivity involving the contralateral thalamus, which is also associated with bigger and more stable tremor measured with an accelerometer. They also found stronger cross-hemisphere coupling between left and right thalami leading to more unstable tremor.
https://academic.oup.com/brain/advance-article/doi/10.1093/brain/awae387/7909131
