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Responsive Versus Continuous Deep Brain Stimulation for Speech in Essential Tremor: A Pilot Study.

Stephanie Cernera1, Sarah Long1, Madison Kelberman1

  • 1J. Crayton Pruitt Department of Biomedical Engineering, Gainesville, Florida, USA.

Movement Disorders : Official Journal of the Movement Disorder Society
|June 15, 2024
PubMed
Summary

Responsive deep brain stimulation (rDBS) for essential tremor (ET) maintained speech intelligibility while effectively suppressing tremors. This suggests rDBS is a promising alternative to continuous DBS (cDBS) for ET patients.

Keywords:
deep brain stimulationessential tremorintelligibilityresponsive stimulationspeech

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Area of Science:

  • Neurology
  • Biomedical Engineering

Background:

  • Responsive deep brain stimulation (rDBS) delivers therapy only when physiological signals indicate need.
  • rDBS may mitigate speech side effects common with continuous deep brain stimulation (cDBS) in essential tremor (ET).

Purpose of the Study:

  • To evaluate if rDBS can reduce speech-related side effects compared to cDBS.
  • To assess if rDBS maintains tremor suppression efficacy in ET patients.

Main Methods:

  • Eight ET participants with thalamic DBS were assessed under DBS OFF, cDBS ON, and rDBS ON conditions.
  • Speech intelligibility was rated, and tremor severity was measured using the Fahn-Tolosa-Marin Tremor Rating Scale (TRS).

Main Results:

  • Unilateral cDBS significantly reduced speech intelligibility (P=0.025).
  • rDBS did not negatively impact speech intelligibility.
  • Both rDBS (P=0.026) and cDBS (P=0.038) improved contralateral tremor scores.

Conclusions:

  • rDBS effectively suppresses tremors in ET patients without compromising speech intelligibility.
  • Further investigation with a larger prospective chronic study of rDBS in ET is warranted.