{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T02:24:44Z","timestamp":1794018284380,"version":"4.8.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The ventral intermediate nucleus of the thalamus (VIM) is an effective target for deep brain stimulation (DBS) to control symptoms related to essential tremor. The VIM is typically targeted using indirect methods, although studies have reported visualization of the VIM on proton density\u2013weighted MRI. This study compares the outcomes between patients who underwent VIM DBS with direct and indirect targeting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Between August 2013 and December 2019, 230 patients underwent VIM DBS at the senior author\u2019s institution. Of these patients, 92 had direct targeting (direct visualization on proton density 3-T MRI). The remaining 138 patients had indirect targeting (relative to the third ventricle and anterior commissure\u2013posterior commissure line).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Coordinates of electrodes placed with direct targeting were significantly more lateral (p &lt; 0.001) and anterior (p &lt; 0.001) than those placed with indirect targeting. The optimal stimulation amplitude for devices measured in voltage was lower for those who underwent direct targeting than for those who underwent indirect targeting (p &lt; 0.001). Patients undergoing direct targeting had a greater improvement only in their Quality of Life in Essential Tremor Questionnaire hobby score versus those undergoing indirect targeting (p = 0.04). The direct targeting group had substantially more symptomatic hemorrhages than the indirect targeting group (p = 0.04). All patients who experienced a postoperative hemorrhage after DBS recovered without intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Patients who underwent direct VIM targeting for DBS treatment of essential tremor had similar clinical outcomes to those who underwent indirect targeting. Direct VIM targeting is safe and effective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2021.2.jns203815","type":"journal-article","created":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T20:57:41Z","timestamp":1632517061000},"page":"662-671","source":"Crossref","is-referenced-by-count":15,"title":["Direct targeting of the ventral intermediate nucleus of the thalamus in deep brain stimulation for essential tremor: a prospective study with comparison to a historical cohort"],"prefix":"10.3171","volume":"136","author":[{"given":"Andre A.","family":"Wakim","sequence":"first","affiliation":[{"name":"Department of Medical Education, Creighton University School of Medicine, Phoenix;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha A.","family":"Sioda","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Creighton University School of Medicine, Phoenix;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Lambert","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virgilio Gerald H.","family":"Evidente","sequence":"additional","affiliation":[{"name":"Movement Disorders Center of Arizona, Scottsdale, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco A.","family":"Ponce","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph\u2019s Hospital and Medical Center, Phoenix; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Annu Rev Neurosci","first-page":"229","article-title":"Deep brain stimulation","volume":"29","author":"Perlmutter JS","year":"2006","unstructured":"Perlmutter JS, Mink JW. 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