{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:53:28Z","timestamp":1791568408439,"version":"4.3.4"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,10]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> Tremors, including its proximal component, are often refractory to standard thalamic surgery. In the 1960s the posterior part of the subthalamic white matter was reported to be a promising target in treating various forms of tremor, but was also found to be associated with adverse effects. Advances involving a less invasive method, that is, deep brain stimulation (DBS), has led to a reappraisal of this target.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> Eight patients with severe essential tremor involving the proximal arm were treated using unilateral stimulation of the posterior part of the subthalamic white matter. The tentative target was situated in the area lateral to the red nucleus and posteromedial to the subthalamic nucleus. Macrostimulation was used to find the optimal site to suppress tremor. Through a quadripolar DBS lead, somatosensory evoked potentials (SSEPs) were recorded. Improvement of tremor was evaluated based on a modified clinical tremor rating scale. Anatomical locations of all contacts were assessed using stereotactic guidance and represented on the Schaltenbrand\u2014Wahren atlas.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> A characteristic diphasic pattern of SSEPs reaffirmed the electrophysiological endorsement of this target. Tremors, both proximal and distal, were remarkably improved in all patients. The rate of improvement, as indicated by the total tremor score, was a mean of 81%. Axial tremors in the legs and head were also improved. Most of the contacts associated with remarkable improvement were located in the posterior part of the subthalamic white matter (the zona incerta and prelemniscal radiation). Neither major complications nor neurological deterioration was observed. The authors concluded that DBS of the posterior part of the subthalamic white matter together with SSEP recording is a safe and effective method to ameliorate severe intractable tremors.<\/jats:p>","DOI":"10.3171\/jns.2003.99.4.0708","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:49:22Z","timestamp":1242236962000},"page":"708-715","source":"Crossref","is-referenced-by-count":142,"title":["Electrical stimulation of the posterior subthalamic area for the treatment of intractable proximal tremor"],"prefix":"10.3171","volume":"99","author":[{"given":"Jun-ichi","family":"Murata","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayumi","family":"Kitagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruo","family":"Uesugi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisatoshi","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinobu","family":"Iwasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Kikuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunio","family":"Tashiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Sawamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Brain","first-page":"1576","article-title":"Stereotactic lesional surgery for the treatment of tremor in multiple sclerosis: a prospective case-controlled study.","volume":"124","author":"Alusi","year":"2001"},{"key":"b2","series-title":"J Neurosurg","first-page":"860","article-title":"Subthalamotomy in treatment of parkinsonian tremor.","volume":"20","author":"Andy","year":"1963"},{"key":"b3","series-title":"Brain","first-page":"1919","article-title":"Neurophysiological effects of stimulation through electrodes in the human subthalamic nucleus.","volume":"122","author":"Ashby","year":"1999"},{"key":"b4","series-title":"J Neurol Neurosurg Psychiatry","first-page":"666","article-title":"Immediate and long term outcome after infrathalamic and thalamic lesioning for intractable Tourette's syndrome.","volume":"70","author":"Babel","year":"2001"},{"key":"b5","series-title":"Mov Disord","first-page":"S73","article-title":"Mechanisms of deep brain stimulation.","volume":"17","author":"Benabid","year":"2002"},{"key":"b6","series-title":"Stereotact Funct Neurosurg","first-page":"164","article-title":"Functional neuroanatomy of the target area for the treatment of pathological tremor: an electrophysiological approach.","volume":"52","author":"Birk","year":"1989"},{"key":"b7","series-title":"Mov Disord","first-page":"S41","article-title":"Pathophysiology of nonparkinsonian tremors.","volume":"17","author":"Deuschl","year":"2002"},{"key":"b8","series-title":"Brain","first-page":"1001","article-title":"The correlation between tremor characteristics and the predicted volume of effective lesions in stereotaxic nucleus ventralis intermedius thalamotomy.","volume":"106","author":"Hirai","year":"1983"},{"key":"b9","series-title":"Eur J Neurosci","first-page":"4573","article-title":"Identification of the target neuronal elements in electrical deep brain stimulation.","volume":"12","author":"Holsheimer","year":"2000"},{"key":"b10","series-title":"Arch Med Res","first-page":"270","article-title":"Subthalamic prelemniscal radiation stimulation for the treatment of Parkinson's disease: electrophysiological characterization of the area.","volume":"31","author":"Jimenez","year":"2000"},{"key":"b11","series-title":"Electroencephalogr Clin Neurophysiol","first-page":"187","article-title":"Somatosensory evoked potentials from the thalamic sensory relay nucleus (VPL) in humans: correlations with short latency somatosensory evoked potentials recorded at the scalp.","volume":"68","author":"Katayama","year":"1987"},{"key":"b12","series-title":"J Neurosurg","first-page":"314","article-title":"Stereotactically guided thalamotomy for treatment of parkinsonian tremor isolated to the lower extremity. 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