Stimulation of subthalamic nucleus alleviates tremor in Parkinson's disease

STN in the pathophysiology of parkinsonian tremor. STN stimulation can be considered as an alternative to Vim or pallidal surgery, even in patients severely disabled by parkinsonian rest and postural tremor, since it induces a dramatic effect not only on akinesia and rigidity, but also on tremor. In our centre, 49 patients with Vim stimulation for predominant tremor were followed up for longer than 4 years. In 32 (65%) the most disabling symptoms were motor fluctuations, levodopa-induced dyskinesias, or both, whereas tremor was well controlled. In patients with tremor-dominated PD, STN stimulation should be preferred to Vim stimulation since most of these patients will develop disabling akinesia not improved by Vim stimulation.