Thalamic Deep Brain Stimulation for Essential Tremor Also Reduces Voice Tremor

Area of Science:

• Neurology
• Neurosurgery
• Movement Disorders

Background:

• Voice tremor is a challenging symptom of essential tremor (ET), significantly impacting patient quality of life.
• Medical treatments for voice tremor in ET are often ineffective.
• Deep brain stimulation (DBS) of the ventral intermediate nucleus (Vim) is established for limb tremor but its effect on voice tremor is less understood.

Purpose of the Study:

• To retrospectively evaluate the efficacy of Vim-DBS in treating concurrent voice tremor in patients with essential motor tremor.
• To identify optimal lead locations within the Vim for effective voice tremor control.

Main Methods:

• Retrospective cohort study of 77 patients with essential tremor undergoing unilateral or bilateral Vim-DBS.
• Assessment of vocal tremor using the Fahn-Tolosa-Marin (FTM) subscore pre- and post-stimulation.
• Monitoring of tremor changes over up to 12 months.

Main Results:

• 26% of ET patients had pre-existing voice tremor.
• Vim-DBS reduced voice tremor amplitude by 80% (p < 0.001).
• Anterior Vim stimulation, particularly on the left, showed better voice tremor control.

Conclusions:

• Vim-DBS, when used for motor symptoms of ET, effectively reduces voice tremor amplitude.
• This suggests Vim-DBS is a promising treatment option for essential tremor patients experiencing vocal tremor.
• Further investigation into specific stimulation parameters may optimize vocal tremor management.