ReviewJournal of neurology2023
DBS in tremor with dystonia: VIM, GPi or both? A review of the literature and considerations from a single-center experience.
Review in Journal of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Efficacy and safety of multiple-target deep brain stimulation in non-parkinsonian movement disorders: a systematic review.Neurosurgical review · 2025Pooled it
- Simultaneous pallidal and centromedian deep brain stimulation for combined dystonia and drug-resistant epilepsy in a child with hypoxic-ischemic encephalopathy: a technical case report.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Efficacy and safety of single-trajectory posterior subthalamic area and subthalamic nucleus deep brain stimulation for dystonic tremor: a retrospective pilot study.Journal of neurology · 2026Article
- Thalamic Deep Brain Stimulation for Dystonic Head Tremor: A Long-Term Study of 18 Patients.Movement disorders clinical practice · 2026Article
- Deutetrabenazine in Hyperkinetic Movement Disorders: VMAT2 Modulation From Choreiform Disorders to Hyperkinetic Dystonic Syndromes.Journal of central nervous system disease · 2026Review
- Neuroscience of human ventral lateral thalamic nucleus related to movement and movement disorders.Journal of neurophysiology · 2025Review
- Multitarget neurostimulation of the deep brain: clinical opportunities, challenges, and emerging technologies.Journal of neural engineering · 2025Review
- Emerging Deep Brain Stimulation Targets in the Cerebellum for Tremor.Cerebellum (London, England) · 2025Review
- "Deep Brain Stimulation of the Ventral Intermediate Nucleus of the Thalamus for Tremor in Polr3a-Related Tremor-ataxia Syndrome: A Two-case Report".Tremor and other hyperkinetic movements (New York, N.Y.) · 2025Article
- Is thalamic deep brain stimulation the right target to improve laryngeal dystonia symptoms?Dystonia (Lausanne, Switzerland) · 2025Article
- Thalamic ventral-Oralis complex/rostral zona incerta deep brain stimulation for midline tremor.Journal of neurology · 2024Article
- Clinical neurophysiology in the treatment of movement disorders: IFCN handbook chapter.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2024Review
- Head movement dynamics in dystonia: a multi-centre retrospective study using visual perceptive deep learning.NPJ digital medicine · 2024Article
- Effect of Thalamic versus Pallidal Deep Brain Stimulation on Head Tremor in Dystonic and Essential Tremor Patients-A Retrospective Video-Blinded Study.Movement disorders clinical practice · 2024Article
- Vim-PSA Double-Target DBS for the Treatment of Holmes Tremor Secondary to Brainstem Hemorrhage: A Case Report.International medical case reports journal · 2024Article
- The Challenge of Choosing the Right Stimulation Target for Dystonic Tremor-A Series of Instructive Cases.Movement disorders clinical practice · 2023Article
- Globus pallidus internus activity increases during voluntary movement in children with dystonia.iScience · 2023Article
- Radiofrequency ablation of the pallidothalamic tract and ventral intermediate nucleus for dystonic tremor through the parietal approach.Surgical neurology international · 2023Article
- Application of deep brain stimulation for the treatment of childhood-onset dystonia in patients with MEPAN syndrome.Frontiers in neurology · 2023Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDeep brain stimulation (DBS) is an established treatment for dystonia and tremor. However, there is no consensus about the best surgical targeting strategy in patients with concomitant tremor and dystonia. Both the thalamic ventral intermediate nucleus (VIM) and the globus pallidus pars interna (GPi) have been proposed as targets. Few cases using them together in a double-target approach have also been reported.
methodsWe reviewed the literature on this topic, summarizing results of different target choices. Additionally, we retrospectively report a case series of nine patients with sporadic dystonia and severe tremor treated with a double-target strategy at our center. Outcome measures were the Burke-Fahn-Marsden Dystonia Rating Scale (BFM) and Eq-5d scale.
resultsIn published studies of patients with dystonia and tremor, VIM-DBS is highly effective on tremor but raise some concerns about dystonia's control, while GPi-DBS is more effective on dystonia but does not always relieve tremor. GPi + VIM-DBS shows good efficacy but is rarely reported and reserved for selected patients. In our patients, the double-target strategy obtained a significant and durable improvement in tremor, dystonia, and quality of life. Additionally, compared with a cohort of patients with tremor treated with VIM-DBS only, significantly lower frequency and intensity of VIM stimulation were required to control tremor.
conclusionOur findings and published evidence seem to support the double-targeting approach as a safe and effective option in selected patients with tremor-dominant dystonia. This strategy appears to provide a more extensive control of either dystonia or tremor and may have a potential for limiting stimulation-related side effects.
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