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Thalamic deep brain stimulation in the treatment of essential tremor
- Center of Oncology Maria Sklodowska-Curie Memorial Institute, Warsaw, Poland
- department of neurosurgery
- 1 Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University
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Abstract
Quality of life can be severely impaired by essential tremor (ET) being the main cause of the patient's disability. The authors present a group of ET patients treated with deep brain stimulation of the ventral intermediate nucleus of the thalamus (Vim DBS). The aim of the study was to evaluate the efficacy and safety of Vim DBS in the treatment of ET.
Material and methodsBetween 2006 and 2009, 8 female and 10 male ET patients were treated with Vim DBS. Mean age at implantation was 63 ± 15 years. ET lasted from 4 to 30 years (mean 12 years). Clinical condition of the group was evaluated before surgery and 3 months after implantation with spirography (spiral drawings), the modified Fahn (Tremor Rating Scale, TRS) scale, and the modified ADL (Activity of Daily Living) scale. The Vim was localized with CT and MRI. The procedures of implantation were performed under local and general anaesthesia. A bilateral procedure was performed in 11 cases and a unilateral procedure was performed in 7 cases.
ResultsThe therapeutic effect of DBS was maintained at the follow-up in the third month following surgery. Mean contralateral limb tremor reduction was 79%. Head tremor reduction was reported by 75% of patients in the bilateral Vim DBS subgroup and 50% of patients in the unilateral Vim DBS subgroup. Mean ADL score improved by 61%.
ConclusionsVim DBS is a safe and effective method of ET treatment. Vim DBS improves activities of daily living of ET patients.
Abstract
Quality of life can be severely impaired by essential tremor (ET) being the main cause of the patient's disability. The authors present a group of ET patients treated with deep brain stimulation of the ventral intermediate nucleus of the thalamus (Vim DBS). The aim of the study was to evaluate the efficacy and safety of Vim DBS in the treatment of ET.
Material and methodsBetween 2006 and 2009, 8 female and 10 male ET patients were treated with Vim DBS. Mean age at implantation was 63 ± 15 years. ET lasted from 4 to 30 years (mean 12 years). Clinical condition of the group was evaluated before surgery and 3 months after implantation with spirography (spiral drawings), the modified Fahn (Tremor Rating Scale, TRS) scale, and the modified ADL (Activity of Daily Living) scale. The Vim was localized with CT and MRI. The procedures of implantation were performed under local and general anaesthesia. A bilateral procedure was performed in 11 cases and a unilateral procedure was performed in 7 cases.
ResultsThe therapeutic effect of DBS was maintained at the follow-up in the third month following surgery. Mean contralateral limb tremor reduction was 79%. Head tremor reduction was reported by 75% of patients in the bilateral Vim DBS subgroup and 50% of patients in the unilateral Vim DBS subgroup. Mean ADL score improved by 61%.
ConclusionsVim DBS is a safe and effective method of ET treatment. Vim DBS improves activities of daily living of ET patients.
Keywords
essential tremor, deep brain stimulation, thalamus
Title
Thalamic deep brain stimulation in the treatment of essential tremor
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
37-41
Page views
320
Article views/downloads
579
DOI
10.1016/S0028-3843(14)60058-X
Bibliographic record
Neurol Neurochir Pol 2011;45(1):37-41.
Keywords
essential tremor
deep brain stimulation
thalamus
Authors
Tomasz Mandat
Henryk Koziara
Rafał Rola
Wiesław Bonicki
Paweł Nauman