MND: Thalamic Stimulation,  a tremor reduction technique used for Parkinson’s , is gaining traction as a  treatment for severe MS tremors.

But what is the Thalamus?

The function of the Thalamus are primarily (Wiki) processing of sensory information (sight ,touch,…but not smells).

It also involved  in balance and  managing sleep, wakeful states [consciousness?] etc..

See the image of the thalamus within other brain regions  the below

What is “Thalamic stimulation”? Essentially, it consists of  implanting micro-electrodes in that region of the brain and sending “charge-balanced biphasic constant current waveforms or capacitively coupled charge injection approaches are adopted”   The patient moves about with the micro-electrodes implanted and on/off controls.  An article in the Journal of Neurology and Neurosurgical Psychiatry [see source 2] concluded:   ”MS tremor often permanently improves during thalamic stimulation”.

The “wemove” organization has a discussion comparing Thalamotomy and deep brain thalamus stimulation. It does not  no mention MS specifically, but spasticity is an entrance in their categories. Another  comparison in The Walton Centre for Neurology and Neurosurgery, Liverpool, UK, seems to put thalamotomy and thalamic stimulation on par and seems the decision for one or the other would be  case by case. Note that thalamotomy is also used against Parkinson tremors One sentence is interesting ,though:

“…Functional improvement was seen only in 47.8% of those who underwent thalamotomy as opposed to 85.2% of those who had deep brain stimulation..”

WebMD far prefers deep brain simulation. Quoting:”…The effectiveness, lower risk, and nondestructive nature of deep brain stimulation have made it the preferred surgical method for treating Parkinson’s disease…” WebMD article brings in another surgery, pallidotomy, which seems also on it’s way out.

Removing part of the brain does not sound like appendicitis surgery, these parts of the brain are clearly involved in useful activities… No wonder Deep Brain Stimulation is a more common choice…

Talk to your Doctor….

Sources:

  1. wemove.org
  2. Journal of  Neuroly Neurosurgery Psychiatry., 2011 Apr;82(4):419-22. Epub 2010 Sep 30.
  3. Stereotactic neurosurgery for disabling tremor in multiple sclerosis:  Yap L, Kouyialis A, Varma TR.;Department of Neurosurgery, The Walton Centre for Neurology and Neurosurgery, Liverpool, UK.
  4. Wikipedia/ neurostimulation
  5. WebMD, http://www.webmd.com/multiple-sclerosis/guide/deep-brain-stimulation

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