Post subthalamic area deep brain stimulation for tremors: a mini-review

Area of Science:

• Neurosurgery
• Neurology
• Movement Disorders

Background:

• Thalamic ventrointermediate nucleus (VIM) deep brain stimulation (DBS) is standard for essential and parkinsonian tremor.
• Pharmacologically refractory tremors often pose treatment challenges.

Purpose of the Study:

• To review the benefits and limitations of posterior subthalamic area (PSA) DBS compared to VIM DBS.
• To provide insight into managing difficult-to-treat tremors with PSA DBS.

Main Methods:

• Review of recent studies on DBS in the posterior subthalamic area (PSA).
• Comparison of PSA DBS outcomes with traditional VIM DBS for various tremor types.
• Analysis of adverse effect profiles for both targets.

Main Results:

• PSA DBS shows promise for tremors refractory to VIM DBS, including proximal postural and distal intention tremors.
• PSA DBS exhibits a milder, transient adverse effect profile compared to VIM DBS.
• Studies on bilateral PSA DBS are limited with shorter follow-up durations than VIM DBS.

Conclusions:

• PSA DBS is a potential alternative for tremors poorly controlled by VIM DBS.
• Further comparative studies with longer follow-up are necessary to establish PSA DBS efficacy and safety.
• PSA DBS may offer a favorable side effect profile, particularly regarding dysarthria and disequilibrium.