NYMC Faculty Publications
The Safety and Efficacy of Thalamic Deep Brain Stimulation in Essential Tremor: 10 Years and Beyond.
Author Type(s)
Faculty
DOI
10.1136/jnnp-2013-304943
Journal Title
Journal of Neurology, Neurosurgery, and Psychiatry
First Page
567
Last Page
572
Document Type
Article
Publication Date
5-1-2014
Department
Neurology
Keywords
Aged, Aged, 80 and over, Deep Brain Stimulation, Dysarthria, Essential Tremor, Female, Follow-Up Studies, Gait Disorders, Neurologic, Humans, Male, Middle Aged, Thalamus, Time Factors, Treatment Outcome
Disciplines
Medicine and Health Sciences
Abstract
BACKGROUND: Deep brain stimulation (DBS) has proven to be a safe and effective therapy for refractory essential tremor, but information regarding long-term outcomes is lacking.
OBJECTIVES: We aimed to assess the long-term safety and efficacy of DBS in patients with essential tremor.
METHODS: Patients treated with DBS for essential tremor for at least 8 years were evaluated in the 'on' and 'off' state using the Fahn-Tolosa-Marin tremor rating scale, and their medical records were reviewed to assess complications related to this therapy.
RESULTS: We studied 13 patients (7 men): median age at evaluation 79 years (range 47-88), median age at electrode implantation 68 years (range 37-78) and mean time since electrode implantation 132.54±15.3 months (range 114-164). The difference between the 'off' and 'on' state on the motor items of the tremor rating scale was 41.9% (58.62 vs. 34.08, p< 0.001) in the non-blinded and 37.2% (56.07 vs. 35.23, p< 0.001) in the blinded rating. DBS provided a functional improvement of 31.7% in the 'on' state (15.07 vs. 22.07, p< 0.001). A total non-blinded improvement in the tremor rating scale of 39% was observed in the 'on' state (49.15 vs. 80.69, p< 0.001). Dysarthria and disequilibrium were common in patients with bilateral stimulation. A DBS-related surgery (electrode revision or internal pulse generator exchange) was necessary on average every 47.9 months to continue with the DBS therapy.
CONCLUSIONS: Thalamic DBS is a safe and effective therapy in patients with essential tremor followed for up to 13 years.
Recommended Citation
Baizabal-Carvallo, J., Kagnoff, M. N., Jimenez-Shahed, J., Fekete, R., & Jankovic, J. (2014). The Safety and Efficacy of Thalamic Deep Brain Stimulation in Essential Tremor: 10 Years and Beyond.. Journal of Neurology, Neurosurgery, and Psychiatry, 85 (5), 567-572. https://doi.org/10.1136/jnnp-2013-304943
