Long-term efficacy of deep brain stimulation for essential tremor: An observer-blinded study

Neurology
Steffen PaschenGünther Deuschl

Abstract

Deep brain stimulation (DBS) of the ventral intermediate thalamic nucleus (Vim) is established for medically refractory severe essential tremor (ET), but long-term efficacy is controversial. Twenty patients with ET with DBS had standardized video-documented examinations at baseline, in the stimulation-on condition at short term (13.1 ± 1.9 months since surgery, mean ± SEM), and in the stimulator switched on and off (stim-ON/OFF) at long term; all assessments were done between 32 and 120 months (71.9 ± 6.9 months) after implantation. The primary outcome was the Tremor Rating Scale (TRS) blindly assessed by 2 trained movement disorder neurologists. Secondary outcomes were TRS subscores A, B, and C; Archimedes spiral score; and activities of daily living score. At long-term follow-up, tremor was additionally recorded with accelerometry. The rebound effect after switching the stimulator off was assessed for 1 hour in a subgroup. Tremor severity worsened considerably over time in both in the nonstimulated and stimulated conditions. Vim-DBS improved the TRS in the short term and long term significantly. The spiral score and functional measures showed similar improvements. All changes were highly significant. However, the stimulation ...Continue Reading

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Citations

Oct 4, 2019·Movement Disorders : Official Journal of the Movement Disorder Society·Paul KrackGünther Deuschl
Aug 23, 2019·Movement Disorders : Official Journal of the Movement Disorder Society·Alfonso Fasano, Rick C Helmich
Mar 3, 2020·Expert Review of Neurotherapeutics·Joshua K WongMichael S Okun
Sep 12, 2020·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Franziska Hopfner, Günther Deuschl
Oct 6, 2020·Frontiers in Neurology·Sarah C ReitzJohanna Quick-Weller
Oct 22, 2020·Expert Review of Medical Devices·Kai-Liang WangAparna Wagle Shukla
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Jan 4, 2021·Neuromodulation : Journal of the International Neuromodulation Society·Panagiotis BargiotasM Lenard Lachenmayer
Dec 16, 2020·Neurology India·Manmohan Singh, Mohit Agrawal
Dec 16, 2020·Neurology India·Richa Tripathi, Milind Deogaonkar
Apr 14, 2020·Neurologic Clinics·William George Ondo
Dec 31, 2019·Clinical Parkinsonism & Related Disorders·María Carolina Sepúlveda Soto, Alfonso Fasano
Nov 3, 2021·Biomedizinische Technik. Biomedical Engineering·Rene Peter BremmFrank Hertel

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