{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T14:59:20Z","timestamp":1785941960947,"version":"3.56.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background\/objectives<\/jats:title>\n                    <jats:p>Deep brain stimulation (DBS) is an established surgical treatment for essential tremor (ET). Both the thalamic ventral intermediate nucleus (VIM) and the posterior subthalamic area (PSA) are effective tremor targets can be approached through a single trajectory. This technical feasibility report describes a single-trajectory dual-target VIM\u2013PSA DBS surgical protocol using octopolar electrodes and evaluates stereotactic accuracy, anatomical contact distribution, and preliminary surgical safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eleven patients with medication-refractory ET underwent bilateral DBS implantation within the framework of an ongoing randomized, double-blind, crossover clinical trial comparing VIM-DBS and PSA-DBS. Preoperative planning was performed using Brainlab Elements, and postoperative reconstruction was performed using Guide\u2122 XT after fusion of preoperative MRI with one-month postoperative CT. Clinical and electrical data (efficacy outcomes, stimulation thresholds, side-effect thresholds, active contact selection, energy consumption, habituation, patient-reported outcomes, and programming burden) were not assessed in this report.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 22 octopolar DBS leads were implanted. Postoperative reconstruction confirmed anatomical contact distribution across the reconstructed VIM model and the PSA\/cZI target region. Mean planned-to-implanted deviation across contacts was 1.28\u202fmm for the left electrodes and 1.50\u202fmm for the right electrodes. One patient developed transient symptomatic perielectrode edema; no intracerebral hemorrhage or any other major surgery-related adverse event was observed during early postoperative follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Single-trajectory dual-target VIM\u2013PSA DBS using octopolar electrodes was successfully performed with acceptable stereotactic accuracy and without major surgery-related adverse events in this small cohort. The approach may increase anatomical coverage and postoperative programming options. Clinical data remain to be determined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1865673","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T14:21:52Z","timestamp":1785939712000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual-target VIM\u2013PSA deep brain stimulation using octopolar electrodes: surgical technique and feasibility study"],"prefix":"10.3389","volume":"17","author":[{"given":"Luc\u00eda","family":"Triguero-Cueva","sequence":"first","affiliation":[{"name":"Department of Neurology, Hospital Universitario Virgen de las Nieves","place":["Granada, Spain"]},{"name":"IInstituto de Investigaci\u00f3n Biosanitaria ibs. GRANADA","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Pablo","family":"Mart\u00ednez-Barbero","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Hospital Universitario Virgen de las Nieves","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Javier","family":"Madrid-Navarro","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Universitario Virgen de las Nieves","place":["Granada, Spain"]},{"name":"IInstituto de Investigaci\u00f3n Biosanitaria ibs. GRANADA","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"P\u00e9rez-Navarro","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Universitario Virgen de las Nieves","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo","family":"M\u00ednguez-Castellanos","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Universitario Virgen de las Nieves","place":["Granada, Spain"]},{"name":"IInstituto de Investigaci\u00f3n Biosanitaria ibs. GRANADA","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bartolom\u00e9","family":"Mar\u00edn-Romero","sequence":"additional","affiliation":[{"name":"Neuropsychology, Hospital Universitario Virgen de las Nieves","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjam\u00edn","family":"I\u00e1\u00f1ez-Velasco","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitario Virgen de las Nieves","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Escamilla-Sevilla","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Universitario Virgen de las Nieves","place":["Granada, Spain"]},{"name":"IInstituto de Investigaci\u00f3n Biosanitaria ibs. GRANADA","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majed Jouma","family":"Katati","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Universitario Virgen de las Nieves","place":["Granada, Spain"]},{"name":"Department of Surgery, Faculty of Medicine, Granada University","place":["Granada, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1007\/s00415-012-6628-x","article-title":"Treatment of essential tremor: a systematic review of evidence and recommendations from the Italian movement disorders association","volume":"260","author":"Zappia","year":"2013","journal-title":"J Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1002\/mds.27700","article-title":"MDS evidence-based review of treatments for essential 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