open access

Vol 44, No 6 (2010)
Submitted: 2010-04-27
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Thalamic deep brain stimulation for tremor among multiple sclerosis patients

Tomasz Mandat, Henryk Koziara, Marcin Tutaj, Rafał Rola, Wiesław Bonicki, Paweł Nauman
DOI: 10.1016/S0028-3843(14)60150-X
·
Neurol Neurochir Pol 2010;44(6):542-545.

open access

Vol 44, No 6 (2010)
Submitted: 2010-04-27

Abstract

Background and purpose

Disabling tremor might be the main cause of disability of multiple sclerosis (MS) patients. Neuromodulation with deep brain stimulation of the thalamic nucleus ventralis intermedius (Vim DBS) is a well accepted method of neurosurgical treatment of tremor related to essential tremor or Parkinson disease. Vim DBS is not widely used to control MS tremor.

Material and methods

Five MS patients with tremor (3 females and 2 males) were treated with Vim DBS. Age at implantation was 37 ± 5 years. MS lasted from 5 to 12 years (mean 6) and tremor was the main cause of disability of those patients from 2 to 5 years (mean 3) before surgery. Clinical condition of the group was evaluated with spirography, the modified Fahn scale and the modified Activity of Daily Living (ADL) scale. Evaluations were performed before surgery and 3 months after surgery. MRI exclusion criteria were the presence of a thalamic hyperintense signal in T2-weighted images or ventricular enlargement. The procedures of implantation were performed under local and general anaesthesia.

Results

Intensity of contralateral limb tremor during intraoperative macrostimulation was reduced in the whole group. The therapeutic effect of DBS was maintained at three-month follow-up. Mean contralateral limb tremor reduction was 40%. Mean ADL score improved by 18%. No mortality or morbidity was reported in the group.

Conclusions

The study confirms the value and safety of Vim DBS for treatment of MS-related tremor. Further study on a larger population and introduction of a qualification protocol might increase efficacy of the treatment.

Abstract

Background and purpose

Disabling tremor might be the main cause of disability of multiple sclerosis (MS) patients. Neuromodulation with deep brain stimulation of the thalamic nucleus ventralis intermedius (Vim DBS) is a well accepted method of neurosurgical treatment of tremor related to essential tremor or Parkinson disease. Vim DBS is not widely used to control MS tremor.

Material and methods

Five MS patients with tremor (3 females and 2 males) were treated with Vim DBS. Age at implantation was 37 ± 5 years. MS lasted from 5 to 12 years (mean 6) and tremor was the main cause of disability of those patients from 2 to 5 years (mean 3) before surgery. Clinical condition of the group was evaluated with spirography, the modified Fahn scale and the modified Activity of Daily Living (ADL) scale. Evaluations were performed before surgery and 3 months after surgery. MRI exclusion criteria were the presence of a thalamic hyperintense signal in T2-weighted images or ventricular enlargement. The procedures of implantation were performed under local and general anaesthesia.

Results

Intensity of contralateral limb tremor during intraoperative macrostimulation was reduced in the whole group. The therapeutic effect of DBS was maintained at three-month follow-up. Mean contralateral limb tremor reduction was 40%. Mean ADL score improved by 18%. No mortality or morbidity was reported in the group.

Conclusions

The study confirms the value and safety of Vim DBS for treatment of MS-related tremor. Further study on a larger population and introduction of a qualification protocol might increase efficacy of the treatment.

Get Citation

Keywords

multiple sclerosis, tremor, deep brain stimulation

About this article
Title

Thalamic deep brain stimulation for tremor among multiple sclerosis patients

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 44, No 6 (2010)

Pages

542-545

DOI

10.1016/S0028-3843(14)60150-X

Bibliographic record

Neurol Neurochir Pol 2010;44(6):542-545.

Keywords

multiple sclerosis
tremor
deep brain stimulation

Authors

Tomasz Mandat
Henryk Koziara
Marcin Tutaj
Rafał Rola
Wiesław Bonicki
Paweł Nauman

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