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Published on: December 13, 2017
Thalamic deep brain stimulation for tremor among multiple sclerosis patients.
Tomasz Mandat1, Henryk Koziara, Marcin Tutaj
1Klinika Nowotworów Układu Nerwowego, Centrum Onkologii, Instytut im. Marii Skłodowskiej-Curie, ul. Roentgena 5, 02-781 Warszawa. tomaszmandat@yahoo.com
Neurologia I Neurochirurgia Polska
|January 13, 2011
Summary
Deep brain stimulation of the thalamic nucleus ventralis intermedius (Vim DBS) effectively reduced tremor in multiple sclerosis (MS) patients. This safe neuromodulation technique improved daily living activities, offering a promising treatment for MS-related disabling tremor.
Area of Science:
- Neurosurgery
- Neuromodulation
- Neuroscience
Background:
- Disabling tremor is a primary cause of disability in multiple sclerosis (MS) patients.
- Thalamic nucleus ventralis intermedius deep brain stimulation (Vim DBS) is established for essential tremor and Parkinson's disease.
- Vim DBS is underutilized for managing MS-related tremor.
Purpose of the Study:
- To evaluate the efficacy and safety of Vim DBS in treating tremor in MS patients.
- To assess the impact of Vim DBS on tremor intensity and daily living activities in MS.
Main Methods:
- Five MS patients with disabling tremor underwent Vim DBS implantation.
- Clinical assessments included spirography, Fahn scale, and Activity of Daily Living (ADL) scale, evaluated pre-surgery and at 3-month follow-up.
- Procedures were performed under local and general anesthesia, with specific MRI exclusion criteria applied.
Main Results:
- Intraoperative macrostimulation demonstrated reduced contralateral limb tremor in all patients.
- A mean tremor reduction of 40% was observed, maintained at the three-month follow-up.
- Mean ADL scores improved by 18%, with no reported mortality or morbidity.
Conclusions:
- Vim DBS is a safe and valuable treatment for MS-related tremor.
- Further research with larger populations and refined qualification protocols could enhance treatment efficacy.
