Article
Statistical prediction of the optimal site for thalamotomy in parkinsonian tremor
Dr. F. A. Lenz,
S. L. Normand,
H. C. Kwan,
D. Andrews,
L. H. Rowland,
M. W. Jones,
M. Seike,
Y. C. Lin,
R. R. Tasker,
J. O. Dostrovsky,
Y. E. Lenz,
Corresponding Author
Dr. F. A. Lenz
Division of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
Department of Neurosurgery, The Johns Hopkins Hospital, Meyer 7-113, 600 North Wolfe Street, Baltimore, MD 21287-7713, U.S.A.Search for more papers by this authorS. L. Normand
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, U.S.A.
Search for more papers by this authorH. C. Kwan
Department of Physiology, University of Toronto, Toronto, Canada
Search for more papers by this authorD. Andrews
Department of Statistics, University of Toronto, Toronto, Canada
Search for more papers by this authorL. H. Rowland
Division of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
Search for more papers by this authorM. W. Jones
Department of Neurosurgery, State University of New York, Syracuse, New York, U.S.A.
Search for more papers by this authorM. Seike
Division of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
Search for more papers by this authorY. C. Lin
Division of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
Search for more papers by this authorR. R. Tasker
Department of Surgery, University of Toronto, Toronto, Canada
Search for more papers by this authorJ. O. Dostrovsky
Department of Physiology, University of Toronto, Toronto, Canada
Search for more papers by this authorY. E. Lenz
Division of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
Search for more papers by this authorDr. F. A. Lenz,
S. L. Normand,
H. C. Kwan,
D. Andrews,
L. H. Rowland,
M. W. Jones,
M. Seike,
Y. C. Lin,
R. R. Tasker,
J. O. Dostrovsky,
Y. E. Lenz,
Corresponding Author
Dr. F. A. Lenz
Division of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
Department of Neurosurgery, The Johns Hopkins Hospital, Meyer 7-113, 600 North Wolfe Street, Baltimore, MD 21287-7713, U.S.A.Search for more papers by this authorS. L. Normand
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, U.S.A.
Search for more papers by this authorH. C. Kwan
Department of Physiology, University of Toronto, Toronto, Canada
Search for more papers by this authorD. Andrews
Department of Statistics, University of Toronto, Toronto, Canada
Search for more papers by this authorL. H. Rowland
Division of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
Search for more papers by this authorM. W. Jones
Department of Neurosurgery, State University of New York, Syracuse, New York, U.S.A.
Search for more papers by this authorM. Seike
Division of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
Search for more papers by this authorY. C. Lin
Division of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
Search for more papers by this authorR. R. Tasker
Department of Surgery, University of Toronto, Toronto, Canada
Search for more papers by this authorJ. O. Dostrovsky
Department of Physiology, University of Toronto, Toronto, Canada
Search for more papers by this authorY. E. Lenz
Division of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
Search for more papers by this authorAbstract
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.
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