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Published on: December 13, 2017
Unilateral thalamic deep brain stimulation in essential tremor demonstrates long-term ipsilateral effects
Zhongxing Peng-Chen1, Takashi Morishita, David Vaillancourt
1Department of Neurology, University of Florida, Movement Disorders Center, Gainesville, FL, USA; University for Development, Av. Plaza 680, San Carlos de Apoquindo, Las Condes, Santiago, Chile.
Unilateral thalamic Deep Brain Stimulation (DBS) for essential tremor (ET) significantly improves tremors on both the ipsilateral and contralateral sides. This approach offers a safer alternative for select patients, reducing risks associated with bilateral surgery.
Area of Science:
- Neurology
- Neurosurgery
- Movement Disorders
Background:
- Deep Brain Stimulation (DBS) of the thalamus is effective for essential tremor (ET) but bilateral procedures increase risks.
- Unilateral DBS is explored as a potentially safer alternative to bilateral surgery for ET.
Purpose of the Study:
- To evaluate the ipsilateral tremor benefits of unilateral thalamic DBS in essential tremor patients.
- To assess the long-term efficacy and safety of unilateral DBS for ET.
Main Methods:
- Medication-refractory ET patients received unilateral thalamic DBS.
- Patients were followed longitudinally, with tremor scores assessed at baseline, 6 months, and over 3 years.
- Tremor scores (total motor, arm, ADL) were recorded with DBS ON and OFF.
Main Results:
- Twenty-two patients showed significant long-term improvements (p < 0.05) in total tremor, ADL, and arm tremor on both ipsilateral and contralateral sides.
- Improvements were noted at 6 months and maintained over 3 years of follow-up.
- Ipsilateral arm tremor improvement was approximately 56%, compared to 73% on the contralateral side.
Conclusions:
- Unilateral thalamic DBS provides significant long-term benefits for ipsilateral tremors in ET patients.
- This approach can be considered for high-risk individuals and select ET patients.
- Unilateral DBS may offer a safer treatment option compared to bilateral procedures.
