Acute effects of thalamic deep brain stimulation and thalamotomy on sensorimotor cortex local field potentials in essential tremor

ObjectiveEssential tremor (ET) is characterized by an action tremor believed to be due to excessive theta–alpha activity in the cerebello–thalamo–cortical system. This study aimed to test the hypothesis that therapeutic thalamic stimulation in patients with ET decreases theta–alpha oscillatory activity in primary motor (M1) and sensory (S1) cortices.MethodsDuring surgical treatment of ET in 10 patients, an electrocorticography (ECoG) strip electrode was placed temporarily over the arm region of M1 and S1. Local field potentials (LFP) were recorded at rest, during a tremor-inducing posture, during acute therapeutic thalamic stimulation, and following therapeutic thalamotomy (three patients). Power spectral density (PSD) was calculated using the Fast Fourier Transform.ResultsAt rest, alpha activity (8–13 Hz) in M1 was significantly decreased during high-frequency stimulation, while theta activity (4–8 Hz) decreased in S1. Following thalamotomy, theta and beta (13–30 Hz) was increased in M1. Induction of postural tremor reduced M1 theta, alpha and beta activity compared to the resting state.ConclusionsHigh-frequency thalamic deep brain stimulation (DBS) significantly reduces alpha oscillatory activity in the primary motor cortex of patients with ET, though this change is probably not critical for therapeutic efficacy.SignificanceWe demonstrate that ECoG can be effectively used to study the effect of subcortical stimulation on cortical oscillations.

► High-frequency thalamic deep brain stimulation (DBS), but not thalamotomy, significantly reduces alpha oscillatory activity in the primary motor cortex of patients with essential tremor (ET).
► Thalamotomy does not reduce alpha oscillatory activity, indicating that alpha desynchronization is not essential to the therapeutic efficacy of deep brain stimulation (DBS) in the treatment of essential tremor (ET).
► ECoG can be effectively used to study the effect of subcortical stimulation on cortical oscillations.