{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T15:14:13Z","timestamp":1785338053123,"version":"3.55.0"},"reference-count":19,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:00:00Z","timestamp":1696291200000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiological Reports"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Essential tremor (ET) is a common disease in the elderly population. Severe, medication\u2010refractory ET may require surgical intervention via ablation or deep brain stimulation (DBS). Thalamic Vim (Ventral intermediate nucleus), targeted indirectly using atlas\u2010based coordinates, is the classical target in these procedures. We present a case of an ET patient with a non\u2010MR\u2010compatible cardiac orphaned leads who was a candidate for DBS surgery. Due to the lead constraints of MR use, we used a head computed tomography (CT) with contrast media as the reference exam to define the AC, PC, and midline, and to register and indirectly target the Vim. For target validation, we used intraoperative electrophysiological recordings and intraoperative CT. We implanted bilateral directional leads at the target location. We used the\u2010essential\u2010tremor\u2010rating\u2010assessment\u2010scale (TETRAS) pre and postoperatively to clinically evaluate tremor. Intraoperative micro\u2010electrode recordings (MERs) showed individual tremor cells and a robust increase in normalized root mean square (NRMS) indicating entry to the Vim. Postoperative visualization using lead\u2010DBS along with dramatic clinical improvements show that we were able to accurately target the Vim. Our results show that CT\u2010only registration and planning for thalamic Vim DBS is feasible, and that MERs and intraoperative CT are useful adjuncts for Vim target validation.<\/jats:p>","DOI":"10.14814\/phy2.15730","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T07:59:42Z","timestamp":1696319982000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Electrophysiology\u2010aided <scp>DBS<\/scp> targeting the ventral intermediate nucleus in an essential tremor patient with <scp>MRI<\/scp>\u2010incompatible lead: A case report"],"prefix":"10.14814","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3928-3637","authenticated-orcid":false,"given":"Stefanie","family":"Glowinsky","sequence":"first","affiliation":[{"name":"The Edmond and Lily Safra Center for Brain Sciences Hebrew University  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagai","family":"Bergman","sequence":"additional","affiliation":[{"name":"The Edmond and Lily Safra Center for Brain Sciences Hebrew University  Jerusalem Israel"},{"name":"Department of Medical Neurobiology Hebrew University  Jerusalem Israel"},{"name":"Department of Neurosurgery Hadassah Medical Center, Hebrew University  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Zarchi","sequence":"additional","affiliation":[{"name":"Intraoperative Neurophysiology Unit Rabin Medical Center, Beilinson Hospital  Petach Tikvah Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shlomo","family":"Fireman","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Rabin Medical Center, Beilinson Hospital  Petach Tikvah 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