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Neuropsychological functioning in a patient with essential tremor with and without bilateral VIM stimulation
J A Lucas1, J D Rippeth, R J Uitti
1Department of Psychology, Mayo Clinic Jacksonville, FL 32224, USA.
Brain and Cognition
|April 4, 2000
Summary
Deep brain stimulation significantly improved motor function and manual dexterity in an essential tremor patient. Cognitive performance remained stable, though verbal fluency and recall declined without stimulation.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Essential tremor is a chronic neurological disorder impacting motor control.
- Deep brain stimulation (DBS) is a therapeutic option for refractory essential tremor.
- Thalamic DBS targets the ventral intermediate nucleus for tremor suppression.
Observation:
- An 80-year-old male with essential tremor underwent bilateral thalamic DBS.
- Post-surgery assessments evaluated motor, cognitive, and mood functions with and without stimulation.
- Tremor ratings and manual dexterity showed significant improvement with active stimulation.
Findings:
- Bilateral thalamic stimulation effectively reduced tremor and improved dexterity.
- Cognitive functions including visuospatial perception, attention, and memory were unaffected by stimulation status.
- Verbal fluency and recall showed significant decline when stimulation was turned off.
- Mood ratings indicated increased distress in the absence of stimulation.
Implications:
- Thalamic DBS is effective for motor symptoms in essential tremor.
- Cognitive functions may be preserved during thalamic DBS, but verbal fluency/recall are sensitive to stimulation.
- Maintaining continuous stimulation is crucial for optimal cognitive and mood benefits in essential tremor patients.
