Physiological study of presumed ventralis intermedius neurons in the human thalamus

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✓ Unitary or a group of unitary responses recorded extracellularly in the rostral part of the thalamic sensory nucleus during the course of thalamotomy for parkinsonian and other kinds of tremor were studied. They were the first sensory neurons encountered in the frontocaudal approach of the stereotaxic needle to the therapeutic target at the lower border of the ventralis intermedius nucleus. The spike discharges, isolated from high neural noise background, responded to passive and/or active movement of joint or muscle on the contralateral extremity but never to light tactile stimuli. In five cases, electrical stimulation of the corresponding peripheral nerves elicited the same spike discharge at short and fixed latency of about 12 msec. Weak electrical stimulation given to each thalamic point produced paresthetic or electric sensation around the receptive field, and stronger stimulation induced tremor-like movement in the area involving the receptive field. Finally, a small coagulation lesion in this thalamic point resulted in immediate relief of tremor without any sensory deficit.

From these findings, the possibility is considered that in the human, this particular thalamic zone could be the ventralis intermedius nucleus, which is separable from the surrounding nuclei and is related to tremor mechanism.

Article Information

Address for Dr. Narabayashi: Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.Address reprint requests to: Chihiro Ohye, M.D., Department of Neurosurgery, Gunma University School of Medicine, 3–39 Showa-machi, Maebashi, Gunma, Japan.

© AANS, except where prohibited by US copyright law.

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Figures

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    Thalamic points where kinesthetic neurons were recorded (dots) are shown with their respective tracks. Drawing is reconstructed from an x-ray film, showing the posterior commissure (CP) and intercommissural line (horizontal line), and superimposed on the corresponding sagittal plane (L = 15) of the thalamus (Schaltenbrand and Bailey27).

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    Responses of a group of thalamic neurons (R-Thal) at two different levels. A: Response to the passive dorsiflexion of the ankle joint, indicated by deflexion of the second trace. B1: Rhythmic burst discharge approximately synchronous with the tremor, revealed by electromyography of the contralateral (left) forearm extensor (L-E). B2: The same neurons responded to passive flexion of interphalangeal joint of the second through fourth fingers (indicated by an arrow and deflexion of the second trace).

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    Responses of thalamic neurons (r-Thal) at two different levels. A: Response to the compression of the contralateral rectus muscle, indicated by deflexion of the third trace (signal). The second trace is the electromyogram of the tibialis anterior muscle (L-Ta). B: The next group of neurons responded to rapid (1) and slow (2) stretch of the gastrocnemius muscle by passive dorsiflexion of the ankle joint.

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    A: Response of thalamic neurons (L-Thal) to passive flexion of the interphalangeal joint of the contralateral first finger (arrow) as illustrated in B. C and D: The same neuron responded to electrical stimulation (arrows) of the right radial nerve (R-Rad.N.) at the wrist. Recordings were photographically twice enlarged. Note the difference in time scale.

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    Thalamic responses to electrical stimulation of the peripheral nerves at the wrist level. A and B: Contralateral (left) median nerve (med. N.) stimulation. C and D: Contralateral ulnar nerve (uln. N.) stimulation. T = Threshold value for eliciting slow potential by median nerve stimulation.

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    Same patient as illustrated in Fig. 4. Motor effect of the electrical stimulation of the thalamic point shown in Fig. 4 at two different intensities. Electromyograms (EMG's) from the contralateral (right) upper limb are demonstrated. R-B = right biceps brachii; R-T = right triceps brachii; R-F = right forearm flexor; R-E = right forearm extensor. Note that the effect is only manifested on forearm EMG's.

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