Universität zu Köln

Pedrosa, David J., Brown, Peter, Cagnan, Hayriye ORCID: 0000-0002-1641-115X, Visser-Vandewalle, Veerle, Wirths, Jochen, Timmermann, Lars and Brittain, John-Stuart ORCID: 0000-0002-4172-190X (2018). A functional micro-electrode mapping of ventral thalamus in essential tremor. Brain, 141. S. 2644 - 2655. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2156

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Abstract

Deep brain stimulation enables the delivery of therapeutic interventions to otherwise inaccessible areas of the brain while, at the same time, offering the unique opportunity to record from these same regions in awake patients. The posterior ventrolateral thalamus has become a reliable deep brain stimulation target for medically-refractory patients suffering from essential tremor. However, the contribution of the thalamus in essential tremor, and even whether posterior ventrolateral thalamus is the optimal target, remains a matter of ongoing debate. There are several lines of evidence supporting clusters of activity within the posterior ventrolateral thalamus that are important for tremor emergence. In this study we sought to map the functional properties of these clusters through microelectrode recordings during deep brain stimulation surgery. Data were obtained from 10 severely affected patients with essential tremor (12 hemispheres) undergoing deep brain stimulation surgery. Our results demonstrate power and coherence maxima located in the inferior posterior ventrolateral thalamus and immediate ventral region. Moreover, we identified distinct yet overlapping clusters of predominantly efferent (driving) and afferent (feedback) activity, with a preference for more efferent contributors, consistent with a net role in the driving of tremor output. Finally, we demonstrate that resolvable thalamic spiking activity directly relates to background activity and that the strength of tremor may be dictated by phase relationships between efferent and afferent pockets in the posterior ventrolateral thalamus. Taken together, these results provide important evidence for the role of the inferior posterior ventrolateral thalamus and its border region in essential tremor pathophysiology. Such results progress our mechanistic understanding and promote the adoption of next-generation therapies such as high resolution segregated deep brain stimulation electrodes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pedrosa, David J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brown, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Cagnan, Hayriye UNSPECIFIED orcid.org/0000-0002-1641-115X UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Wirths, Jochen UNSPECIFIED UNSPECIFIED UNSPECIFIED Timmermann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Brittain, John-Stuart UNSPECIFIED orcid.org/0000-0002-4172-190X UNSPECIFIED
URN:	urn:nbn:de:hbz:38-173534
DOI:	10.1093/brain/awy192
Journal or Publication Title:	Brain
Volume:	141
Page Range:	S. 2644 - 2655
Date:	2018
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2156
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DEEP BRAIN-STIMULATION; MOTOR THALAMUS; CEREBELLAR THALAMUS; GRANGER CAUSALITY; COHERENCE; NETWORKS; OSCILLATIONS; TRIAL Multiple languages Clinical Neurology; Neurosciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17353