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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Deep brain stimulation: relevant fibre tracts involved in the alleviation of parkinsonian tremor

Meeting Abstract

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  • Jürgen Schlaier - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Quirin Strotzer - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Judith Anthofer - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Max Lange - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Rupert Faltermeier - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland
  • Alexander Brawanski - Universitätsklinikum Regensburg, Klinik und Poliklinik für Neurochirurgie, Regensburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV200

doi: 10.3205/18dgnc203, urn:nbn:de:0183-18dgnc2037

Veröffentlicht: 18. Juni 2018

© 2018 Schlaier et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

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Objective: The aim of our study was to investigate which cerebral fibre tracts are involved in the alleviation of parkinsonian tremor in deep brain stimulation.

Methods: 21 patients with Parkinson’s disease and bilaterally implanted electrodes in the subthalamic nucleus were investigated. In 6 of those patients parkinsonian tremor was present in 11 hemibodies contralateral to the investigated brain-hemispheres. Diffusion weighted images (DWI) with 64 gradient directions were included in the routine preoperative imgaging procedure for deep brain stimulation. Post-operative CT scans were fused to the DWI data set and the position of the individual contacts of the electrodes were determined. Probabilistic fibretracking was performed with seed regions based on each individual contact of the electrodes and the resulting anatomical fibre tracts were determined. We compared the depicted fibre tracts between contacts, which effectively (<=2V) reduced the tremor (> 50%) with the fibre tracts of contacts that did not.

Results: 14 (31.8%) of the 44 contacts achieved a reduction of the contralateral tremor (>50%) with an amplitude <= 2.0V. Effective contacts were significantly more often associated with the fasciculus thalamicus, the ansa and fasciculus lenticularis, and fibres passing through the zona incerta (p<0.05) than non-effective contacts. Fibres of the ipsi- and contralateral dentate-rubro-thalamic tract were not depicted differently between effective and non-effective contacts.

Conclusion: As opposed to essential tremor, in parkinsonian tremor the dentate-rubro-thalamic tract does not seem to be the anatomical structure involved in tremor reduction. More likely, stimulated pallido-thalamic fibres play the major role concerning the alleviation of parkinsonian tremor.