Session Information
Date: Tuesday, June 6, 2017
Session Title: Tremor
Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
Objective: To explore cortico-thalamic biomarkers of intention tremor and intentional movement in hand Primary Motor (M1) and Premotor (PM) Cortex, and Ventral Intermediate Thalamic Nucleus (VIM) in patients with Essential Tremor to be used to clinically validate an effective responsive Deep Brain Stimulation (DBS) treatment.
Background: Essential Tremor (ET) is defined as a rhythmical, involuntary oscillatory movement of the limbs. Intention tremor is present in the upper limbs (slow oscillations, ~4-12 Hz) during the initiation and execution of goal-directed reaching motions, while it is absent at rest. It has currently been suggested that a synchronous pathological oscillation in a network that includes PM, M1, VIM and cerebellum is suppressed with DBS by jamming the “tremor cells” in the thalamus.
Methods: Two patients were implanted in both cortical (PM, M1) and thalamic (VIM) regions and recorded during a DBS implantation surgery. Together with inertial and EMG collected data, it was possible to explore biomarkers related to movement intention/execution, and to tremor. These biomarkers can be reliably used to responsively deliver DBS.
Results: It was shown that it is possible to achieve single trial detection of movement intention/execution from PM, M1 and Vim. Pilot data collected from cortical strips implanted for a different cohort (Tourette’) show reliable detection capabilities in Medtronic PC+S devices, which will also be used in our responsive ET cohort.
Conclusions: Our results suggest that a reliable control of responsive DBS is possible with the use of a single or a combination of targeted brain areas. This enhanced DBS therapy solution would decrease the possible patient’s side effects, such as balance and speech impairment, and slow down battery depletion, by being inactive during non-tremor statuses, while delivering an equally effective treatment.
To cite this abstract in AMA style:
E. Opri, J. Shute, R. Molina, K. Foote, M. Okun, A. Gunduz. Cortico-thalamic Biomarkers for a Responsive Deep Brain Stimulation: an enhanced Treatment of Essential Tremor. [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/cortico-thalamic-biomarkers-for-a-responsive-deep-brain-stimulation-an-enhanced-treatment-of-essential-tremor/. Accessed November 22, 2024.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/cortico-thalamic-biomarkers-for-a-responsive-deep-brain-stimulation-an-enhanced-treatment-of-essential-tremor/