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Deep brain stimulation and tremor.

Kelly E Lyons1, Rajesh Pahwa

  • 1Parkinson's Disease and Movement Disorder Center, Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas 66160, USA. lyons.kelly@att.net

Neurotherapeutics : the Journal of the American Society for Experimental Neurotherapeutics
|April 9, 2008
PubMed
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Deep brain stimulation (DBS) offers sustained relief for essential tremor (ET) and other disabling tremors. This safe and effective treatment, particularly bilateral DBS, shows significant, long-lasting benefits for medication-resistant cases.

Area of Science:

  • Neurology
  • Neurosurgery

Background:

  • Deep brain stimulation (DBS) is a long-established treatment for tremor disorders.
  • Medication-resistant essential tremor (ET) is the most common indication for DBS.
  • While effective for ET, its utility in multiple sclerosis and post-traumatic tremor is less consistent.

Purpose of the Study:

  • To review the efficacy and safety of DBS for various tremor disorders.
  • To compare DBS outcomes in essential tremor versus other tremor types.
  • To highlight current DBS targets and potential complications.

Main Methods:

  • Review of existing literature on DBS for tremor disorders.
  • Analysis of reported benefits, duration of effect, and complications.
  • Comparison of outcomes based on tremor etiology and surgical target.

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Main Results:

  • DBS provides significant and sustained (up to 7 years) benefit for essential tremor, especially with bilateral procedures.
  • Improvements are noted in upper extremity, head, and voice tremors.
  • DBS shows less consistent and more transient benefits for multiple sclerosis and post-traumatic tremors.
  • The ventral intermediate nucleus of the thalamus is a common target, with the subthalamic area (zona incerta) also showing promise.
  • Surgical complications are infrequent and generally less severe than thalamotomy.

Conclusions:

  • Deep brain stimulation is a safe and effective treatment for medication-resistant essential tremor.
  • DBS may also benefit certain cases of multiple sclerosis and post-traumatic tremor.
  • Target selection and bilateral stimulation can optimize outcomes for tremor control.