Caudal Zona Incerta (cZI) / Posterior Subthalamic Area (PSA)
Disorders Treated with Stimulation
- Primary indications: Tremor (including essential tremor, Holmes tremor, dystonic tremor and tremor related to PD and MS) [1]
Location
- The cZI is the posterior / caudal portion of the broader Zona Incerta nucleus. It is positioned between the substantia nigra and subthalamic nucleus. [2] The cZI and prelemniscal radiations together comprise the PSA.
Associated Tracts
- DRTT: The cZI is along the course of the DRTT as it traverses from the level of the RN to the Level of the thalamus. Targeting the cZI targets several cerebello-thalamo-cortical fiber tracts involved in motor control, most notably the DRTT. [2, 3]
References
- Xie, T., Bernard, J., & Warnke, P. (2012). Post subthalamic area deep brain stimulation for tremors: a mini-review. Translational Neurodegeneration, 1
- Neudorfer C, Kultas-Ilinsky K, Ilinsky I, Paschen S, Helmers AK, Cosgrove GR, Richardson RM, Horn A, Deuschl G. The role of the motor thalamus in deep brain stimulation for essential tremor. Neurotherapeutics. 2024 Apr;21(3):e00313. doi: 10.1016/j.neurot.2023.e00313. Epub 2024 Jan 8. PMID: 38195310; PMCID: PMC11103222
- Sudhyadhom A, Haq IU, Foote KD, Okun MS, Bova FJ. A high resolution and high contrast MRI for differentiation of subcortical structures for DBS targeting: the Fast Gray Matter Acquisition T1 Inversion Recovery (FGATIR). Neuroimage. 2009 Aug;47 Suppl 2:T44-52. doi: 10.1016/j.neuroimage.2009.04.018. Epub 2009 Apr 10. PMID: 19362595