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MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor
Published on: December 13, 2017
Steady or not following thalamic deep brain stimulation for essential tremor
Nelson Hwynn1, Christopher J Hass, Pamela Zeilman
1Department of Neurology, McKnight Brain Institute, University of Florida, 100 S. Newell Drive, Rm L3-100, Gainesville, Fl, 32610, USA.
Journal of Neurology
|March 29, 2011
Summary
Deep brain stimulation (DBS) for essential tremor (ET) may worsen gait. Higher baseline tremor severity scores indicate a greater risk of post-operative gait impairment in ET patients receiving DBS.
Area of Science:
- Neurology
- Neurosurgery
- Movement Disorders
Background:
- Deep brain stimulation (DBS) is a key treatment for medication-refractory essential tremor (ET).
- However, DBS may lead to gait disturbances and falls in ET patients.
- Understanding gait changes post-DBS is crucial for patient management.
Purpose of the Study:
- To evaluate gait impairment in essential tremor patients after deep brain stimulation.
- To identify factors associated with post-operative gait worsening.
Main Methods:
- Retrospective review of 38 essential tremor patients undergoing DBS targeting the nucleus ventralis intermediate (Vim).
- Analysis of gait and balance before and after unilateral or bilateral DBS implantation.
- Assessment of factors including age, disease duration, pre-morbid gait issues, and tremor rating scale (TRS) scores.
Main Results:
- 58% of patients experienced worsened gait post-DBS.
- Higher baseline Fahn-Tolosa-Marin tremor rating scale (TRS) scores were associated with worsened gait (p=0.002).
- Unilateral DBS showed a higher percentage of gait worsening (70%) compared to bilateral (55%), potentially due to surgical bias.
Conclusions:
- Gait and balance can deteriorate after DBS for essential tremor.
- Elevated baseline tremor severity may predict post-operative gait problems.
- Further prospective studies with control groups are needed to confirm these findings.
