Vim, referring to the ventralis intermedius nucleus of the thalamus, is a crucial surgical target for treating tremor [1,2,3,4,5,6]. It lies at the boundary between the motor and sensory thalamus, and its neurons respond to passive joint movements and are synchronous with peripheral tremor. The cerebello-rubro-thalamic pathway is associated with Vim, and the dentato-rubro-thalamic tract has been suggested as an optimal target for controlling tremor, though this is yet to be fully corroborated [1,2].

The difficulty in directly visualizing Vim with conventional imaging methods has led to the development of various techniques to locate it for surgical procedures. Stereotactic procedures often use indirect calculations based on references like the mid-commissural line and third ventricle, which vary between patients [1,2]. Newer techniques such as tractography and the Vim line technique aim to improve targeting accuracy. Tractography can visualize the cerebello-rubro-thalamic pathway to help locate Vim, but it has limitations and requires standardization [1,2]. The Vim line technique, created using a mathematical model, has shown promise in determining Vim's location, as demonstrated by decreased Unified Parkinson's Disease Rating Scale (UPDRS) scores in patients after thalamotomy [3,4]. Deep brain stimulation (DBS) of Vim is also an effective treatment for essential tremor, and studies on programming sessions and double-target DBS (Vim-PSA) have explored its long-term efficacy and surgical techniques [5,6].

In conclusion, Vim is of great significance in the treatment of tremor. The development of techniques to accurately locate Vim, such as tractography and the Vim line technique, along with studies on DBS, contribute to improving the treatment of tremor-related diseases. These efforts help in better understanding the role of Vim in tremor-related biological processes and provide more effective treatment strategies [1,2,3,4,5,6].

References:

1. Parras, O, Domínguez, P, Tomás-Biosca, A, Guridi, J. 2020. The role of tractography in the localization of the Vim nucleus of the thalamus and the dentato-rubro-thalamic tract for the treatment of tremor. In Neurologia, 37, 691-699. doi:10.1016/j.nrl.2019.09.006. https://pubmed.ncbi.nlm.nih.gov/31917004/

2. Parras, O, Domínguez, P, Tomás-Biosca, A, Guridi, J. 2021. The role of tractography in the localisation of the Vim nucleus of the thalamus and the dentatorubrothalamic tract for the treatment of tremor. In Neurologia, 37, 691-699. doi:10.1016/j.nrleng.2019.09.008. https://pubmed.ncbi.nlm.nih.gov/34563477/

3. Fahmi, Achmad, Subianto, Heri, Nugraha, Priya, Taira, Takaomi, Bajamal, Abdul Hafid. . VIM Line Technique for Determining the Ventral Intermediate Location. In Turkish neurosurgery, 31, 601-606. doi:10.5137/1019-5149.JTN.31961-20.2. https://pubmed.ncbi.nlm.nih.gov/33978218/

4. Fahmi, Achmad, Subianto, Heri, Nugraha, Priya, Taira, Takaomi, Bajamal, Abdul Hafid. 2020. Vim line technique thalamotomy for Parkinson tremor: Case series. In International journal of surgery case reports, 77, 573-575. doi:10.1016/j.ijscr.2020.11.096. https://pubmed.ncbi.nlm.nih.gov/33395848/

5. Reitz, Sarah C, Luger, Sebastian, Lapa, Sriramya, Baudrexel, Simon, Quick-Weller, Johanna. 2020. Comparing Programming Sessions of Vim-DBS. In Frontiers in neurology, 11, 987. doi:10.3389/fneur.2020.00987. https://pubmed.ncbi.nlm.nih.gov/33013651/

6. Hou, Xusheng, Mo, Yixiang, Zhu, Zhiyuan, Li, Mengqian, Zhang, Shizhong. 2023. Technical Issues of Vim-PSA Double-Target DBS for Essential Tremor. In Brain sciences, 13, . doi:10.3390/brainsci13040566. https://pubmed.ncbi.nlm.nih.gov/37190531/

7. Narabayashi, H. . Stereotaxic Vim thalamotomy for treatment of tremor. In European neurology, 29 Suppl 1, 29-32. doi:. https://pubmed.ncbi.nlm.nih.gov/2653835/