視床刺激療法（Vim-DBS）—振戦に対する視床中間腹側核刺激電極植え込み手術手技

Surgical Technique of Ventral Intermediate Thalamic Deep Brain Stimulation

Point

・通常，視床神経核の可視化は困難であるため，典型的な電極留置部位の座標決定方法を学ぶことが大切である．

・微小電極記録では，somatotopyと運動誘発電位・感覚誘発電位から電極位置を推測することができる．

・治療用電極留置時の試験刺激は，振戦制御効果と刺激誘発性副作用出現閾値を確認する上で非常に有用な手技である．

　Deep brain stimulation（DBS）of ventral intermediate（Vim）thalamic nucleus is an established procedure for tremor disorders, however, there are technical variations among specialists. The most common indications of Vim DBS are essential tremor（ET）and tremor dominant Parkinson's disease（PD）, and less commonly other tremor disorders including Holmes tremor are treated with the same procedure. The variations of the surgical technique exist in the preoperative imagings and planning of the DBS electrode trajectory. In this review, we explain about the basic concept of Vim DBS and our surgical method.