Statistical prediction of the optimal site for thalamotomy in parkinsonian tremor

Mov Disord. 1995 May;10(3):318-28. doi: 10.1002/mds.870100315.

Abstract

Stereotactic lesions in the thalamus for treatment of parkinsonian tremor are often made at the location where neurons fire at approximately tremor frequency (tremor cells). Some of these cells show a large amount of activity at tremor frequency and are significantly correlated with electromyographic activity (EMG) during tremor. Our analysis of cellular location identifies a cluster of neurons showing activity characterized both by concentration of power at tremor frequency and by significant correlation with EMG. In a retrospective analysis of results in 15 patients, lesions placed within 2 mm of the center of this cluster were uniformly effective in relieving tremor. Therefore, a small lesion targeting this cluster is effective in treatment of parkinsonian tremor.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Brain Mapping / methods*
  • Confidence Intervals
  • Electromyography / statistics & numerical data
  • Evoked Potentials / physiology
  • Fourier Analysis
  • Humans
  • Mathematical Computing*
  • Neurons / physiology
  • Parkinson Disease / physiopathology
  • Parkinson Disease / surgery*
  • Retrospective Studies
  • Signal Processing, Computer-Assisted*
  • Stereotaxic Techniques / statistics & numerical data*
  • Synaptic Transmission
  • Thalamic Nuclei / physiopathology
  • Thalamic Nuclei / surgery*
  • Treatment Outcome
  • Tremor / physiopathology
  • Tremor / surgery*