Tremor and disability outcomes following deep brain stimulation for multiple sclerosis-associated tremor

Tremor in multiple sclerosis (MS) is often refractory to medications. Deep brain stimulation (DBS) may help, but possible side effects and disease exacerbation limit its use.

Evaluate outcomes of DBS for MS-associated tremor.

Retrospective review of 18 patients with MS-associated tremor who underwent DBS, analyzing Expanded Disability Status Scale (EDSS) and Fahn-Tolosa-Marin (FTM) tremor scores.

Median age at surgery was 49.5 years (range, 28-75), with postoperative follow-up 2.5 years (range, 0-22). No relapses (0/18) or new lesions (0/8) occurred postoperatively. All had ventral intermediate nucleus leads; other targets were not used in programming. EDSS remained stable (median 6 to 6.25; p = 0.2). FTM scores improved (median 14.5 to 10, p = 0.008). Patients with EDSS 3.5-6 had variable outcomes (p = 0.02).

DBS is a potential treatment for severe MS tremor and did not provoke relapse. Targeting VIM alone may optimize tremor control and maintain magnetic resonance imaging (MRI) access.