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Related Experiment Video

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Precise stimulation location optimizes speech outcomes in essential tremor.

Joseph Y Matsumoto1, Tepanta Fossett2, Minsoo Kim1

  • 1Department of Neurology, Mayo Clinic College of Medicine, 100 2nd Street Southwest, Rochester, MN 55905, United States.

Parkinsonism & Related Disorders
|September 6, 2016
PubMed
Summary
This summary is machine-generated.

Precise deep brain stimulation (DBS) targeting the ventral lateral posterior nucleus (VLp) improves speech outcomes in essential tremor (ET) patients. Avoiding stimulation outside the VLp is crucial for preventing dysarthria and voice tremor.

Keywords:
Deep brain stimulationDysarthriaEssential tremorSpeech

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Area of Science:

  • Neurosurgery
  • Neurology
  • Speech Science

Background:

  • Deep brain stimulation (DBS) for essential tremor (ET) can cause speech problems like dysarthria and voice tremor.
  • Identifying the precise stimulation location is key to managing these side effects.

Purpose of the Study:

  • To investigate the relationship between the location of thalamic stimulation and speech outcomes in patients with essential tremor undergoing bilateral DBS.
  • To determine if specific stimulation parameters correlate with the development of dysarthria or voice tremor.

Main Methods:

  • Bilateral thalamic deep brain stimulation (DBS) was performed on 18 patients with essential tremor (ET).
  • Speech outcomes were assessed by speech pathologists, categorizing patients into normal speech, voice tremor, or dysarthria groups.
  • Active lead locations were normalized to the Morel atlas, and stimulation volumes within thalamic nuclei were analyzed relative to outcome groups.

Main Results:

  • Optimal speech outcomes were achieved in 44% of patients, while 22% developed non-disabling dysarthria.
  • Stimulation volumes were concentrated within the ventral lateral posterior nucleus (VLp).
  • Higher percentages of stimulation volume outside the VLp and greater error distances from the VLp center were associated with poorer speech outcomes (dysarthria, voice tremor).

Conclusions:

  • Precise targeting and stimulation within the ventral lateral posterior nucleus (VLp) are critical for achieving optimal speech outcomes in essential tremor (ET) patients undergoing DBS.
  • Stimulation outside the VLp is linked to an increased risk of developing dysarthria and voice tremor.