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Published on: December 13, 2017
On-demand deep brain stimulation for essential tremor: a report on four cases
Martin Kronenbuerger1, Christoph Fromm, Frank Block
1Department of Neurology, University Hospital, RWTH Aachen, Germany. martin_kronenbuerger@web.de
Summary
On-demand deep brain stimulation (DBS) for essential tremor (ET) is feasible and prevents tolerance. This approach offers stable tremor suppression, conserves battery life, and reduces costs for long-term ET management.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Deep brain stimulation (DBS) is a recognized treatment for essential tremor (ET).
- A significant challenge with continuous DBS is the potential development of tolerance, leading to reduced efficacy over time.
Observation:
- This study investigated the feasibility and efficacy of on-demand DBS in four ET patients.
- Patients were instructed to activate left-thalamic DBS only during right-hand motor tasks, with follow-up up to 30 months.
Findings:
- Patients successfully utilized on-demand DBS, with daily usage averaging 22.0+/-13.5%.
- On-demand DBS provided stable suppression of right arm tremor throughout the study period.
- No instances of tremor rebound or late-stage therapy failure, indicative of tolerance, were observed.
Implications:
- On-demand DBS is a viable strategy for essential tremor management.
- This approach conserves battery life, extending the interval between stimulator replacements and reducing healthcare costs.
- Implementing on-demand DBS may mitigate tolerance development, offering a more sustainable long-term therapeutic option for ET patients.
