Tremor induced by thalamic deep brain stimulation in patients with complex regional facial pain
Tremor induced by thalamic deep brain stimulation in patients with complex regional facial pain
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DOI：
10.1002/mds.20047
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发表时间：
2004-08-01
影响因子：
8.6
通讯作者：
Honey, CR
中科院分区：
文献类型：
--
作者：
Constantoyannis, C;Kumar, A;Honey, CR
我们报告两名患者谁开发了一个新的姿势和动作震颤后，慢性刺激对侧丘脑（VPM核）在治疗复杂的区域性面部疼痛综合征。震颤仅在脑深部电刺激（DBS）期间出现，并通过调整刺激参数得到抑制。震颤仅在低频刺激（50 Hz或更低）下观察到，并在较高的刺激频率下消失。除了是丘脑DBS的一个不寻常的副作用，我们认为，这种现象提供了一个潜在的特发性震颤（ET）的可能机制的见解。涉及橄榄小脑复合体和丘脑的中枢振荡机制是丘脑-小脑-大脑回路的一部分，被认为在ET的发生中起重要作用。在我们的患者中诱导类似ET的震颤表明低频刺激的积极作用。一个合理的解释是，丘脑区域的低频刺激增强了震颤产生网络的输出。这导致信任的概念，中央振荡的“震颤电路”，其中丘脑是一部分，是重要的ET。(C)2004年，《运动障碍协会》。
We report on two patients who developed a new postural and action tremor after chronic stimulation of the contralateral thalamus (VPM nucleus) during treatment of a complex regional facial pain syndrome. The tremor was only present during deep brain stimulation (DBS) and was suppressed with adjustment of the stimulation parameters. Tremor was seen only with low frequency stimulation (50 Hz or lower) and disappeared with higher stimulation frequencies. In addition to being an unusual side effect of thalamic DBS, we believe that this phenomenon affords insight into one possible mechanism underlying essential tremor (ET). A central oscillatory mechanism involving the olivocerebellar complex and the thalamus, which is a part of the cerebro-cerebello-cerebral circuit, is thought to play an important role in the genesis of ET. Induction of a tremor resembling ET in our patients indicates an active role for low frequency stimulation. A plausible explanation for this is that low frequency stimulation in the thalamic area enhances the output of the tremor-producing network. This leads credence to the concept of central oscillations in a "tremor circuit," of which the thalamus is a part, as being important in ET. (C) 2004 Movement Disorder Society.