title: Deep brain stimulation of the nucleus ventralis intermedius: a thalamic site of graviceptive modulation.
abstract: Based on animal studies, it has been shown that the nucleus ventralis intermedius (VIM) of the thalamus plays an important role within the vestibular system. A few human studies support the vestibular role of the VIM. In this study, we aimed to test the hypothesis whether changing the stimulation status in patients with unilateral deep brain stimulation in the VIM causally modulates the vestibular system, i.e., the graviceptive vertical perception. We tested six tremor patients for tilt of subjective visual vertical (SVV) with unilateral DBS in the VIM (mean age 67 years; mean time since electrode implantation 55 months). The mean tilt of the patients during the stimulator "on" condition was 1.4° to the contraversive side [standard deviation (SD) ± 0.4°] whereas during the "off" period a mean contraversive tilt of 4.4° (SD ± 3.0°) was obtained (p = 0.02). Thus, we were able to show that otolith-dominated graviceptive vertical perception can be directly modulated by changing the status of DBS VIM stimulation, indicating that the VIM is directly involved in (contraversive) vertical perception and its thalamic pathways.
authors.affiliation: Department of Neurology, Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany. baierb@uni-mainz.de.|Neurology Department, Edith-Stein Fachklinik, Bad Bergzabern, Germany. baierb@uni-mainz.de.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Baier
authors.affiliation: Department of Neurology, Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Vogt
authors.affiliation: Department of Neurology, Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Rohde
authors.affiliation: Department of Neurology, Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany.|Neurology Department, Edith-Stein Fachklinik, Bad Bergzabern, Germany.
authors.forename: Hannah
authors.initials: H
authors.lastname: Cuvenhaus
authors.affiliation: Department of Neurology and IFBLMU, Ludwig-Maximilians-University, Munich, Germany.|Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Conrad
authors.affiliation: Department of Neurology and IFBLMU, Ludwig-Maximilians-University, Munich, Germany.|Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
authors.forename: Marianne
authors.initials: M
authors.lastname: Dieterich
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation; D005260:Female; D018466:Gravity Sensing / Q000502:physiology*; D006801:Humans; D008297:Male; D014202:Tremor / Q000503:physiopathology; D020651:Ventral Thalamic Nuclei / Q000502:physiology*; D014722:Vestibule, Labyrinth / Q000502:physiology*
keywords: Deep brain stimulation; Thalamus; VIM; Vestibular system