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Introduction: Functional thalamic surgery is known for alleviating isolated focal hand dystonia; however, the optimal target site in the thalamus is not determined. This study aimed to identify effective sites for thalamic deep brain stimulation (DBS) in treating this condition. Methods: Four patients presenting with focal hand dystonia underwent thalamic DBS. Effective stimulation sites were identified through a combination of physiological and radiological mapping. Results: All patients exhibited significant improvement in their hand dystonia. The most effective stimulation sites were localized in the anterior regions of the ventral intermedius nucleus (Vim), involving both Vim and the ventro-oral nucleus (VO). Conclusion: Thalamic DBS proves highly effective in managing focal hand dystonia. The identified effective stimulation sites suggest the involvement of both the pallidothalamocortical and cerebellothalamocortical pathways in its pathophysiology.

Journal Section:
Clinical Study
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S. Karger AG, Basel
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2025
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