title: Statistical prediction of the optimal site for thalamotomy in parkinsonian tremor.
abstract: Stereotactic lesions in the thalamus for treatment of parkinsonian tremor are often made at the location where neurons fire at approximately tremor frequency (tremor cells). Some of these cells show a large amount of activity at tremor frequency and are significantly correlated with electromyographic activity (EMG) during tremor. Our analysis of cellular location identifies a cluster of neurons showing activity characterized both by concentration of power at tremor frequency and by significant correlation with EMG. In a retrospective analysis of results in 15 patients, lesions placed within 2 mm of the center of this cluster were uniformly effective in relieving tremor. Therefore, a small lesion targeting this cluster is effective in treatment of parkinsonian tremor.
authors.affiliation: Division of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland 21287-7713, USA.
authors.forename: F A
authors.initials: FA
authors.lastname: Lenz
authors.forename: S L
authors.initials: SL
authors.lastname: Normand
authors.forename: H C
authors.initials: HC
authors.lastname: Kwan
authors.forename: D
authors.initials: D
authors.lastname: Andrews
authors.forename: L H
authors.initials: LH
authors.lastname: Rowland
authors.forename: M W
authors.initials: MW
authors.lastname: Jones
authors.forename: M
authors.initials: M
authors.lastname: Seike
authors.forename: Y C
authors.initials: YC
authors.lastname: Lin
authors.forename: R R
authors.initials: RR
authors.lastname: Tasker
authors.forename: J O
authors.initials: JO
authors.lastname: Dostrovsky
mesh_terms: D001931:Brain Mapping / Q000379:methods*; D016001:Confidence Intervals; D004576:Electromyography / Q000706:statistics & numerical data; D005071:Evoked Potentials / Q000502:physiology; D005583:Fourier Analysis; D006801:Humans; D008432:Mathematical Computing; D009474:Neurons / Q000502:physiology; D010300:Parkinson Disease / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012815:Signal Processing, Computer-Assisted; D013238:Stereotaxic Techniques / Q000706:statistics & numerical data*; D009435:Synaptic Transmission; D013787:Thalamic Nuclei / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014202:Tremor / Q000503:physiopathology / Q000601:surgery*