{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T01:34:24Z","timestamp":1780882464709,"version":"3.54.1"},"reference-count":33,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,9,5]],"date-time":"2018-09-05T00:00:00Z","timestamp":1536105600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Direct targeting of the dentato\u2010rubro\u2010thalamic tract is efficacious in DBS for tremor suppression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We sought to compare outcomes and optimal stimulation parameters for tremor control using the technique of directly targeting the dentato\u2010rubro\u2010thalamic tract to those who underwent indirect targeting of the ventral intermediate nucleus thalamus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty consecutive essential tremor patients obtained preoperative diffusion MRIs, where the dentato\u2010rubro\u2010thalamic tract was individually drawn and used to directly target the ventral intermediate nucleus of the thalamus during surgery. These patients were compared to an earlier cohort of 20 consecutive patients who underwent surgery using atlas\u2010based coordinates. Baseline and 1\u2010year postsurgery tremor amplitude using The Essential Tremor Rating Assessment Scale was recorded, as were the parameters needed for successful tremor control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The indirectly targeted group had greater baseline and postop tremor severity relative to those directly targeted (baseline, 2.9 vs. 2.6; <jats:italic>P<\/jats:italic>\u2009=\u20090.02; postop, 1.1 vs. 0.8; <jats:italic>P<\/jats:italic>\u2009=\u20090.03). Mean voltage, pulse width, and frequency for optimal tremor control in the directly targeted group (38 electrodes)\u2009=\u20092.8\u2009V, 80\u2009\u03bcs, 153\u2009Hz; the parameters for the indirectly targeted group (38 electrodes)\u2009=\u20092.9\u2009V, 86\u2009\u00b5s, 179\u2009Hz (significantly greater, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Both groups had significant improvement in arm tremor amplitude from baseline (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) without sustained side effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Direct targeting of the dentato\u2010rubro\u2010thalamic tract provides excellent tremor control, comparable to indirectly targeting the ventral intermediate nucleus of the thalamus. Use of lower stimulation parameters, especially frequency, to control tremor in the directly targeted group suggests that it is a more efficient targeting methodology, which may minimize battery depletion. \u00a9 2018 International Parkinson and Movement Disorder Society<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.27463","type":"journal-article","created":{"date-parts":[[2018,9,6]],"date-time":"2018-09-06T01:09:07Z","timestamp":1536196147000},"page":"1895-1901","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Comparison of tractography\u2010assisted to atlas\u2010based targeting for deep brain stimulation in essential tremor"],"prefix":"10.1002","volume":"33","author":[{"given":"Albert J.","family":"Fenoy","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School University of Texas Health Science Center at Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mya C.","family":"Schiess","sequence":"additional","affiliation":[{"name":"Department of Neurology, McGovern Medical School University of Texas Health Science Center at Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01411439"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)91175-T"},{"key":"e_1_2_8_4_1","first-page":"39","article-title":"Chronic VIM thalamic stimulation in Parkinson's disease, essential tremor and extra\u2010pyramidal dyskinesias","volume":"58","author":"Benabid AL","year":"1993","journal-title":"Acta Neurochir Suppl (Wien)"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.84.2.0203"},{"issue":"3","key":"e_1_2_8_6_1","first-page":"2","article-title":"Consensus statement of the Movement Disorder Society on Tremor. 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