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Case Report: Effect of DBS in a Patient With Cerebellar Atrophy
Amanda K Salisbury1, Anna L Brucker1,2, Aleksandra Zakharova3
1Research Department, CHOCResearch, Rady's Children's Health, Orange, CA, USA.
Journal of Child Neurology
|August 3, 2026
Summary
Deep brain stimulation (DBS) in the globus pallidus internus (GPi) and ventral anterior nucleus (VA) effectively reduced dystonic tremor and ataxia in a patient with cerebellar atrophy. This suggests DBS may benefit cerebellar-origin movement disorders.
Area of Science:
- Neurology
- Neurosurgery
- Movement Disorders
Background:
- Deep brain stimulation (DBS) is established for basal ganglia disorders but less understood for cerebellar-origin conditions.
- Progressive cerebellar atrophy can cause complex symptoms including dystonic tremor, ataxia, and psychiatric issues.
- This case report focuses on a patient with unknown etiology cerebellar atrophy and associated movement and psychiatric symptoms.
Purpose of the Study:
- To report the efficacy of DBS targeting the globus pallidus internus (GPi) and ventral anterior nucleus (VA) in a patient with dystonic tremor secondary to cerebellar atrophy.
- To evaluate the impact of DBS on motor and disability symptoms over a 1-year postoperative period.
Main Methods:
- A patient with dystonic tremor from progressive cerebellar atrophy underwent DBS implantation in the GPi and VA.
- Target selection involved clinical assessment and stereoelectroencephalography (sEEG) with neuromodulation monitoring.
- Symptom severity was assessed preoperatively and 1 year postoperatively using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS), Barry Albright Dystonia Scale (BADS), and Scale for Assessment and Rating of Ataxia (SARA).
Main Results:
- Significant improvement in movement symptoms was observed 1 year after DBS implantation and programming.
- BFMDRS movement scores improved from 15.5 to 8; BFMDRS disability scores improved from 13 to 8.
- BADS scores decreased from 14 to 7, and SARA scores improved from 20.5 to 14.5, indicating reduced dystonia and ataxia.
Conclusions:
- DBS targeting the GPi and VA demonstrated beneficial effects on multiple symptoms in a patient with cerebellar degeneration.
- The precise mechanisms of DBS efficacy in this context may involve multiple pathways, potentially beyond direct cerebellar modulation.
- This case highlights the potential role of DBS in managing symptoms of cerebellar-origin disorders and suggests further research is warranted.
