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Objective tremor registration during DBS surgery for essential tremor.

Spiridon Papapetropoulos1, Bruno V Gallo, Alexandra Guevara

  • 1Division of Movement Disorders, Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL 33136, United States. spapapetropoulos@med.miami.edu

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Summary

Objective tremor quantification using a portable device significantly improved assessment during deep brain stimulation (DBS) for Essential Tremor (ET). This method supplements subjective clinical evaluations for better patient outcomes.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Essential Tremor (ET) is a neurological disorder causing involuntary shaking, often in the upper limbs.
  • Deep Brain Stimulation (DBS) targeting the thalamus (Vim nucleus) is an effective treatment for severe or refractory ET.
  • Current intra-operative tremor assessment relies on subjective clinical evaluations.

Observation:

  • A case study involving a 76-year-old woman with medically refractory ET undergoing unilateral DBS.
  • Tremor was objectively monitored pre- and intra-operatively using an accelerometer-based device (Tremor Pen).

Findings:

  • Device-based tremor quantification revealed a 34.7-fold improvement in the contralateral limb post-macro-stimulation.
  • No significant tremor reduction was observed in the ipsilateral (non-operated) limb.

Implications:

  • Objective, device-based tremor registration can supplement subjective clinical measures during DBS procedures.
  • This technology offers a more precise method for evaluating tremor response to surgical interventions.
  • Potential for improved patient management and treatment efficacy in Essential Tremor.