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Thalamic Deep Brain Stimulation in Essential Tremor Plus Is as Effective as in Essential Tremor
Open AccessArticle

Selecting the Most Effective DBS Contact in Essential Tremor Patients Based on Individual Tractography

1
Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, 50923 Köln, Germany
2
Cognitive Neuroscience, Research Center Jülich, Institute of Neuroscience and Medicine (INM-3), 52428 Jülich, Germany
3
Institute of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, University of Cologne, 50923 Köln, Germany
*
Author to whom correspondence should be addressed.
Both authors contributed equally to this work.
Brain Sci. 2020, 10(12), 1015; https://doi.org/10.3390/brainsci10121015
Received: 13 November 2020 / Revised: 26 November 2020 / Accepted: 17 December 2020 / Published: 20 December 2020
(This article belongs to the Special Issue Deep Brain Stimulation in Essential Tremor)
Postoperative choice of the most effective deep brain stimulation (DBS) contact in patients with essential tremor (ET) so far relies on lengthy clinical testing. Previous studies showed that the postoperative effectiveness of DBS contacts depends on the distance to the dentatorubrothalamic tract (DRTT). Here, we investigated whether the most effective DBS contact could be determined from calculating stimulation overlap with the individual DRTT. Seven ET patients with bilateral thalamic deep brain stimulation were included retrospectively. Tremor control was assessed for each contact during test stimulation with 2mA. Individual DRTTs were identified from diffusion tensor imaging and contacts were ranked by their stimulation overlap with the respective DRTT in relation to their clinical effectiveness. A linear mixed-effects model was calculated to determine the influence of the DRTT overlap on tremor control. In 92.9% of investigated DBS leads, the contact with the best clinical effect was the contact with the highest or second-highest DRTT-overlap. At the group level, the DRTT-overlap explained 26.7% of the variance in the clinical outcomes (p < 0.001). Our data suggest that the overlap with the DRTT based on individual tractography may serve as a marker to determine the most effective DBS contact in ET patients and reduce burdensome clinical testing in the future. View Full-Text
Keywords: essential tremor; dentatorubrothalamic tract; volume of tissue activated; deep brain stimulation; tractography; automated programming essential tremor; dentatorubrothalamic tract; volume of tissue activated; deep brain stimulation; tractography; automated programming
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MDPI and ACS Style

Petry-Schmelzer, J.N.; Dembek, T.A.; Steffen, J.K.; Jergas, H.; Dafsari, H.S.; Fink, G.R.; Visser-Vandewalle, V.; Barbe, M.T. Selecting the Most Effective DBS Contact in Essential Tremor Patients Based on Individual Tractography. Brain Sci. 2020, 10, 1015. https://doi.org/10.3390/brainsci10121015

AMA Style

Petry-Schmelzer JN, Dembek TA, Steffen JK, Jergas H, Dafsari HS, Fink GR, Visser-Vandewalle V, Barbe MT. Selecting the Most Effective DBS Contact in Essential Tremor Patients Based on Individual Tractography. Brain Sciences. 2020; 10(12):1015. https://doi.org/10.3390/brainsci10121015

Chicago/Turabian Style

Petry-Schmelzer, Jan N.; Dembek, Till A.; Steffen, Julia K.; Jergas, Hannah; Dafsari, Haidar S.; Fink, Gereon R.; Visser-Vandewalle, Veerle; Barbe, Michael T. 2020. "Selecting the Most Effective DBS Contact in Essential Tremor Patients Based on Individual Tractography" Brain Sci. 10, no. 12: 1015. https://doi.org/10.3390/brainsci10121015

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