Direct targeting of the dentate-thalamic tract (DRTt) in deep brain stimulation (DBS) is an effective strategy for tremor suppression, according to a recent study. 20 consecutively enrolled intention tremor patients (mean age, 66.8 years; mean duration of tremor, 16 years) obtained pre-operative MRI with diffusion tensor (dTi) sequences. Mean voltage for the L electrode=3.4 V; R=2.6 V; mean distance from the center of the active electrode contact to the DRTt was 0.9 mm on the L, and 0.8 mm on the R. Mean baseline tremor amplitude based on The Essential Tremor Rating Assessment Scale was recorded. Researchers found:

• Accounting for hardware, software, and model limitations, depiction of the DRTt allows for placement of electrode contacts directly within the fiber tract for modulation despite any anatomical variation, which reproducibly resulted in good tremor control.
• Improvement in arm tremor amplitude from baseline after DBS was significant.