Tremor recording and analysis as a tool for target localisation in thalamotomy and DBS for tremor

The objective of this work was to design and use a tremor recording and analysis system for stereotactic thalamotomy and thalamus stimulation (DBS). A notebook PC based system was developed. The tremor was measured by accelero-transducers or EMG. The method was used to confirm the definitive localization of the coagulation or stimulation target. Intra-operatively recorded effects of stimulation on the tremor were reproducible. Thermocoagulation and electrode implantation were done only after a significant reduction of the tremor was recorded on thalamic stimulation between 75 and 125 Hz. This method has been used on 9 patients: 2 underwent DBS implantation. It is concluded that intra-operative monitoring of the tremor during ventrolateral thalamotomy or stimulation is useful for identifying the final target for coagulation or electrode implantation.