Observational studyActa neurochirurgica2020
The dentato-rubro-thalamic tract as the potential common deep brain stimulation target for tremor of various origin: an observational case series.
Observational study in Acta neurochirurgica, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 1 synthesis or guideline pooled it, 104 citations in OpenAlex.
- Enhancing precision in MRgFUS for tremor treatment: a systematic review of tractography-based VIM targeting approaches.Neurosurgical review · 2025Pooled it
- Deep Brain Stimulation for Arm Tremor: A Randomized Trial Comparing Two Targets.Annals of neurology · 2022Trial
- Directed stimulation of the dentato-rubro-thalamic tract for deep brain stimulation in essential tremor: a blinded clinical trial.The neuroradiology journal · 2022Trial
- PSA and VIM DBS efficiency in essential tremor depends on distance to the dentatorubrothalamic tract.NeuroImage. Clinical · 2020Trial
- Distance to white matter trajectories is associated with treatment response to internal capsule deep brain stimulation in treatment-refractory depression.NeuroImage. Clinical · 2020Trial
- Review
- Surgical Treatment of Tremor Syndromes: A Guide to the Clinician.Movement disorders clinical practice · 2026Review
- How accurate is probabilistic tractography when used to predict the "sweet spot" in deep brain stimulation? Mind the gap!Acta neurochirurgica · 2025Article
- Deep Brain Stimulation for Parkinson's Disease-A Narrative Review.Biomedicines · 2025Review
- Article
- Convergent mapping of a tremor treatment network.Nature communications · 2025Article
- Comparison of structural connectomes for modeling deep brain stimulation pathway activation.NeuroImage · 2025Article
- Involvement of the Cerebellar Peduncles inInternational journal of molecular sciences · 2025Review
- Dentato-rubro-thalamic tract tractography: Constrained spherical deconvolution versus diffusion tensor imaging for essential tremor deep brain stimulation targeting.Surgical neurology international · 2025Article
- Quantitative Tractography-Based Evaluations in Essential Tremor Patients after MRgFUS Thalamotomy.Movement disorders clinical practice · 2024Article
- Functional anatomy of the subthalamic nucleus and the pathophysiology of cardinal features of Parkinson's disease unraveled by focused ultrasound ablation.Science advances · 2024Article
- Thalamic ventral-Oralis complex/rostral zona incerta deep brain stimulation for midline tremor.Journal of neurology · 2024Article
- Multimodal neuroimaging to characterize symptom-specific networks in movement disorders.NPJ Parkinson's disease · 2024Review
- Review
- The role of the motor thalamus in deep brain stimulation for essential tremor.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2024Review
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDeep brain stimulation alleviates tremor of various origins. The dentato-rubro-thalamic tract (DRT) has been suspected as a common tremor-reducing structure. Statistical evidence has not been obtained. We here report the results of an uncontrolled case series of patients with refractory tremor who underwent deep brain stimulation under tractographic assistance.
methodsA total of 36 patients were enrolled (essential tremor (17), Parkinson's tremor (8), multiple sclerosis (7), dystonic head tremor (3), tardive dystonia (1)) and received 62 DBS electrodes (26 bilateral; 10 unilateral). Preoperatively, diffusion tensor magnetic resonance imaging sequences were acquired together with high-resolution anatomical T1W and T2W sequences. The DRT was individually tracked and used as a direct thalamic or subthalamic target. Intraoperative tremor reduction was graded on a 4-point scale (0 = no tremor reduction to 3 = full tremor control) and recorded together with the current amplitude, respectively. Stimulation point coordinates were recorded and compared to DRT. The relation of the current amplitude needed to reduce tremor was expressed as TiCR (tremor improvement per current ratio).
resultsStimulation points of 241 were available for analysis. A total of 68 trajectories were tested (62 dB leads, 1.1 trajectories tested per implanted lead). Tremor improvement was significantly decreasing (p < 0.01) if the distance to both the border and the center of the DRT was increasing. On the initial trajectory, 56 leads (90.3%) were finally placed. Long-term outcomes were not part of this analysis. DISCUSSION: Tremor of various origins was acutely alleviated at different points along the DRT fiber tract (above and below the MCP plane) despite different tremor diseases. DRT is potentially a common tremor-reducing structure. Individual targeting helps to reduce brain penetrating tracts. TiCR characterizes stimulation efficacy and might help to identify an optimal stimulation point.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.