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Comparing Programming Sessions of Vim-DBS.

Sarah C Reitz1, Sebastian Luger1, Sriramya Lapa1

  • 1Department of Neurology, University Hospital, Frankfurt, Germany.

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|October 5, 2020
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Summary
This summary is machine-generated.

Deep brain stimulation (DBS) for essential tremor (ET) maintains efficacy over time. The optimal contact location in the VIM-DBS system for ET patients remained stable, despite initial shifts possibly due to brain changes post-surgery.

Keywords:
DBSVIMbrain shiftessential tremorventralis intermedius nucleus

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Area of Science:

  • Neurology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Essential Tremor (ET) is a progressive neurological disorder causing debilitating tremors.
  • Deep Brain Stimulation (DBS) of the ventral intermediate nucleus of the thalamus (VIM) is a treatment for medically intractable ET.

Purpose of the Study:

  • To investigate if the effective contact location in VIM-DBS for ET changes over time.
  • To determine if changes in contact location indicate a distinct mechanism of efficacy loss beyond tremor progression.

Main Methods:

  • 10 ET patients with bilateral VIM-DBS underwent programming sessions (intraoperative, early post-op, and long-term).
  • Assessed tremor suppression and side effect thresholds at different time points.
  • Compared effective contact choices between intraoperative (T1) and early post-operative (T2) sessions to evaluate brain shift.

Main Results:

  • VIM-DBS demonstrated continuous efficacy in tremor suppression for ET patients over approximately 4 years.
  • No significant changes in effective contact location were observed in long-term evaluations compared to early programming sessions.
  • The most effective intraoperative contact (T1) often differed from the effective post-operative contact (T2), potentially due to post-surgical brain shift.

Conclusions:

  • VIM-DBS provides sustained tremor control for essential tremor.
  • The effective stimulation site in VIM-DBS for ET appears stable long-term, suggesting consistent therapeutic mechanisms.
  • Initial post-surgical brain shift does not preclude long-term efficacy of VIM-DBS in ET.