TY - JOUR
T1 - Effects of thalamic stimulation frequency on intention and postural tremor
AU - Earhart, Gammon M.
AU - Hong, Minna
AU - Tabbal, Samer D.
AU - Perlmutter, Joel S.
N1 - Funding Information:
We thank Michael Falvo, Shannon Hoffman and Rachel Zapf for their assistance with data analysis, Joanne Wagner for her assistance in setting up the data analysis model. This work was supported by NIH grants K01 HD048437, R01 NS041509, and T32 HD007434; PODS II from the Foundation for Physical Therapy; the Greater St. Louis Chapter of the American Parkinson Disease Association (APDA); the APDA Center for Advanced PD Research at Washington University; and the Barnes-Jewish Hospital Foundation (the Elliot H. Stein Family Fund and the Jack Buck Fund for PD Research).
PY - 2007/12
Y1 - 2007/12
N2 - Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) of the thalamus improves essential tremor. Suppression of the amplitude of the postural tremor component with VIM DBS depends on stimulation frequency. The purpose of this study was to determine the effect of DBS frequency on the intention tremor component, that is, tremor that is enhanced by target-directed movement, and to compare it to the effect of DBS frequency on postural tremor in people with essential tremor. We measured tremor frequency and amplitude during trials of postural holding and voluntary reaching between two targets at 10 different stimulation frequency settings between 0 and 185 Hz. Tremor frequency did not change with changes in stimulation frequency. Amplitude suppression of both intention and postural tremor depended on stimulation frequency. Maximal tremor reduction occurred at approximately 130 Hz for both forms of tremor. However, at optimal frequencies, the percent reduction in tremor amplitude relative to the DBS OFF condition was greater for postural than for intention tremor. These results suggest that VIM DBS stimulation frequencies near 130 Hz may provide maximal control of intention and postural tremor. Identification of optimal stimulation settings should consider assessment of intention tremor, not just postural tremor, as intention tremor may not be as well controlled as postural tremor but may be a better gauge for functional benefit.
AB - Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) of the thalamus improves essential tremor. Suppression of the amplitude of the postural tremor component with VIM DBS depends on stimulation frequency. The purpose of this study was to determine the effect of DBS frequency on the intention tremor component, that is, tremor that is enhanced by target-directed movement, and to compare it to the effect of DBS frequency on postural tremor in people with essential tremor. We measured tremor frequency and amplitude during trials of postural holding and voluntary reaching between two targets at 10 different stimulation frequency settings between 0 and 185 Hz. Tremor frequency did not change with changes in stimulation frequency. Amplitude suppression of both intention and postural tremor depended on stimulation frequency. Maximal tremor reduction occurred at approximately 130 Hz for both forms of tremor. However, at optimal frequencies, the percent reduction in tremor amplitude relative to the DBS OFF condition was greater for postural than for intention tremor. These results suggest that VIM DBS stimulation frequencies near 130 Hz may provide maximal control of intention and postural tremor. Identification of optimal stimulation settings should consider assessment of intention tremor, not just postural tremor, as intention tremor may not be as well controlled as postural tremor but may be a better gauge for functional benefit.
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U2 - 10.1016/j.expneurol.2007.08.014
DO - 10.1016/j.expneurol.2007.08.014
M3 - Article
C2 - 17920589
AN - SCOPUS:36048972653
SN - 0014-4886
VL - 208
SP - 257
EP - 263
JO - Experimental Neurology
JF - Experimental Neurology
IS - 2
ER -