Coaxial interleaved stimulation of the thalamus and subthalamus for treatment of Holmes tremor

Hiroki Toda MD, PhD1,2, Namiko Nishida MD, PhD1, and Koichi Iwasaki MD, PhD1
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  • 1 Department of Neurosurgery, Tazuke Kofukai Medical Research Institute and Kitano Hospital, Osaka; and
  • | 2 Department of Neurosurgery, Fukui Red Cross Hospital, Fukui, Japan
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Holmes tremor is often treated with multiple deep brain stimulation (DBS) electrodes. The authors describe a novel technique to suppress the tremors by effectively utilizing a single electrode.

A 16-year-old boy presented with severe right arm tremor following a midbrain injury. A DBS electrode was implanted into the ventral oralis nucleus of the thalamus (VO) and the subthalamic region. While individual stimulation of each target was ineffective, an interleaved dual stimulation of both targets has been effective for 6 years.

Coaxial interleaved stimulation of the VO and the subthalamic region is useful for treating Holmes tremor.

The video can be found here: https://youtu.be/tSwGh3vy68c.

Holmes tremor is often treated with multiple deep brain stimulation (DBS) electrodes. The authors describe a novel technique to suppress the tremors by effectively utilizing a single electrode.

A 16-year-old boy presented with severe right arm tremor following a midbrain injury. A DBS electrode was implanted into the ventral oralis nucleus of the thalamus (VO) and the subthalamic region. While individual stimulation of each target was ineffective, an interleaved dual stimulation of both targets has been effective for 6 years.

Coaxial interleaved stimulation of the VO and the subthalamic region is useful for treating Holmes tremor.

The video can be found here: https://youtu.be/tSwGh3vy68c.

ACKNOWLEDGEMENTS

This study was partially supported by a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (C# 22591625 and C# 26462224 to H.T.).

Contributor Notes

INCLUDE WHEN CITING Published online April 1, 2017; DOI: http://thejns.org/doi/abs/10.3171/2017.4.FocusVid.16510.

CORRESPONDENCE Hiroki Toda, Department of Neurosurgery, Fukui Red Cross Hospital, 2-4-1 Tsukimi, Fukui 918-8501, Japan. email: htoda-nsu@umin.ac.jp.

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