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How has deep brain stimulation of the thalamus been used to reduce essential tremor?

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Diagram of a human brain showing a median sagittal section, highlighting the fourth ventricle and cerebellum in the hindbrain, with labeled anatomical structures including the pons, medulla oblongata, and central canal of the spinal cord. — thalamus Sagittal section of the human brain, showing structures of the cerebellum, brainstem, and cerebral ventricles.

Deep brain stimulation (DBS) is a surgical procedure used to treat essential tremor by implanting an electrode into the thalamus to disrupt abnormal neuronal impulses.12

Specifically, surgeons target the ventral intermediate thalamic nucleus, which receives input from the cerebellum. Research has identified "tremor cells" within this region that oscillate at the same frequency as a patient's limb tremor. By placing an electrode in the ventral intermediate nucleus opposite the more severely affected arm, the stimulation disrupts these aberrant oscillations. This intervention can significantly reduce uncontrollable movements and improve a patient's functional quality of life.21

Because DBS is an invasive procedure, it carries risks such as bleeding in the brain, infection, or hardware-related issues like lead wire breakage. However, unlike permanent ablative surgeries, DBS is reversible, as the electrode system can be removed if necessary.1