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Related Experiment Video

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MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor
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Deep brain stimulation for vocal tremor: a comprehensive, multidisciplinary methodology.

Allen L Ho1, Elizabeth Erickson-Direnzo2, Arjun V Pendharkar1

  • 1Departments of 1Neurosurgery and.

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|June 2, 2015
PubMed
Summary

Essential vocal tremor (EVT) significantly impacts quality of life. This study demonstrates deep brain stimulation (DBS) as a viable treatment, using intraoperative voice evaluation to guide precise electrode placement for improved outcomes.

Keywords:
AC-PC = anterior commissure-posterior commissureDBS = deep brain stimulationEVT = essential vocal tremorFO = fundamental frequencyPD = Parkinson’s diseaseSTN = subthalamic nucleusVim = ventral intermediate nucleusdeep brain stimulationdysphoniaessential tremoressential vocal tremorventral intermediate nucleus

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Area of Science:

  • Neurology
  • Neurosurgery
  • Speech-Language Pathology

Background:

  • Essential vocal tremor (EVT) is a debilitating symptom of essential tremor, causing social and occupational challenges.
  • Current treatments for EVT offer suboptimal outcomes, necessitating novel therapeutic approaches.
  • Deep brain stimulation (DBS) is a potential intervention, but its efficacy in EVT requires systematic investigation.

Observation:

  • A case study involving awake bilateral DBS targeting the ventral intermediate nucleus for severe voice and arm tremor.
  • A comprehensive, multidisciplinary methodology was employed for definitive EVT treatment via DBS.
  • Intraoperative voice evaluation was utilized to guide microelectrode/stimulator placement, a novel approach.

Findings:

  • The study demonstrated the efficacy of a tailored DBS approach for managing severe EVT.
  • Standard pre- and post-DBS assessments confirmed significant improvements in vocal tremor.
  • This represents the first documented use of intraoperative voice analysis to guide DBS for EVT.

Implications:

  • This research highlights DBS as a promising therapeutic option for individuals suffering from severe essential vocal tremor.
  • The described methodology offers a refined approach to DBS surgery for vocal tremor, potentially improving patient outcomes.
  • Further research validating this tailored DBS strategy could lead to improved quality of life for EVT patients.