{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T09:09:23Z","timestamp":1779527363434,"version":"3.53.1"},"reference-count":98,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:p>Tremulous voice is a characteristic feature of a multitude of movement disorders, but when it occurs in individuals diagnosed with essential tremor, it is referred to as essential vocal tremor (EVT). For individuals with EVT, their tremulous voice is associated with significant social embarrassment and in severe cases may result in the discontinuation of employment and hobbies. Management of EVT is extremely difficult, and current behavioral and medical interventions for vocal tremor result in suboptimal outcomes. Deep brain stimulation (DBS) has been proposed as a potential therapeutic avenue for EVT, but few studies can be identified that have systematically examined improvements in EVT following DBS. The authors describe a case of awake bilateral DBS targeting the ventral intermediate nucleus for a patient suffering from severe voice and arm tremor. They also present their comprehensive, multidisciplinary methodology for definitive treatment of EVT via DBS. To the authors\u2019 knowledge, this is the first time comprehensive intraoperative voice evaluation has been used to guide microelectrode\/stimulator placement, as well as the first time that standard pre- and post-DBS assessments have been conducted, demonstrating the efficacy of this tailored DBS approach.<\/jats:p>","DOI":"10.3171\/2015.3.focus1537","type":"journal-article","created":{"date-parts":[[2015,6,1]],"date-time":"2015-06-01T09:07:57Z","timestamp":1433149677000},"page":"E6","source":"Crossref","is-referenced-by-count":26,"title":["Deep brain stimulation for vocal tremor: a comprehensive, multidisciplinary methodology"],"prefix":"10.3171","volume":"38","author":[{"given":"Allen L.","family":"Ho","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Erickson-Direnzo","sequence":"additional","affiliation":[{"name":"Otolaryngology (Head and Neck Surgery), Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun V.","family":"Pendharkar","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Kwang","family":"Sung","sequence":"additional","affiliation":[{"name":"Otolaryngology (Head and Neck Surgery), Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey H.","family":"Halpern","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus1537","series-title":"Semin Speech Lang","first-page":"43","article-title":"Development of a speech treatment program for a client with essential vocal tremor","volume":"32","author":"Barkmeier-Kraemer","year":"2011"},{"key":"b2-focus1537","series-title":"J Neurosurg","first-page":"203","article-title":"Chronic electrical stimulation of the ventralis inter-medius nucleus of the thalamus as a treatment of movement disorders","volume":"84","author":"Benabid","year":"1996"},{"key":"b3-focus1537","series-title":"Appl Neurophysiol","first-page":"344","article-title":"Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease","volume":"50","author":"Benabid","year":"1987"},{"key":"b4-focus1537","series-title":"Neurology","first-page":"796","article-title":"Reduction in voice tremor under thalamic stimulation","volume":"50","author":"Carpenter","year":"1998"},{"key":"b5-focus1537","series-title":"J Voice","first-page":"365","article-title":"Effects of bilateral subthalamic nucleus stimulation and medication on parkinsonian speech impairment","volume":"22","author":"D\u2019Alatri","year":"2008"},{"key":"b6-focus1537","series-title":"Mov Disord","first-page":"1132","article-title":"An investigation of the effects of subthalamic nucleus stimulation on acoustic measures of voice","volume":"15","author":"Dromey","year":"2000"},{"key":"b7-focus1537","series-title":"J Voice","first-page":"444","article-title":"Acoustic voice analysis in patients with essential tremor","volume":"12","author":"Gamboa","year":"1998"},{"issue":"Suppl 3","key":"b8-focus1537","series-title":"Mov Disord","first-page":"S135","article-title":"Intraoperative microelectrode and semi-microelectrode recording during the physiological localization of the thalamic nucleus ventral intermediate","volume":"17","author":"Garonzik","year":"2002"},{"key":"b9-focus1537","series-title":"Brain Lang","first-page":"233","article-title":"Effect of bilateral stimulation of the subthalamic nucleus on parkinsonian voice","volume":"78","author":"Gentil","year":"2001"},{"key":"b10-focus1537","series-title":"Eur Neurol","first-page":"136","article-title":"Effect of bilateral subthalamic nucleus stimulation and dopatherapy on oral control in Parkinson\u2019s disease","volume":"42","author":"Gentil","year":"1999"},{"key":"b11-focus1537","series-title":"Curr Opin Otolaryngol Head Neck Surg","first-page":"155","article-title":"Voice tremor: what we know and what we do not know","volume":"19","author":"Gillivan-Murphy","year":"2011"},{"key":"b12-focus1537","series-title":"Mov Disord","first-page":"2420","article-title":"DYT6 dystonia: mutation screening, phenotype, and response to deep brain stimulation","volume":"25","author":"Groen","year":"2010"},{"key":"b13-focus1537","series-title":"J Neurosurg","first-page":"547","article-title":"Histological analysis of the location of effective thalamic stimulation for tremor. 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