Reduction in voice tremor under thalamic stimulation

Area of Science:

• Neurology
• Neurosurgery

Background:

• Essential tremor (ET) is a common neurological disorder.
• Deep brain stimulation (DBS) is an established treatment for managing hand tremor in ET.
• Voice symptoms can also occur in ET patients, impacting quality of life.

Purpose of the Study:

• To investigate the effect of DBS targeting the ventral intermediate thalamic nucleus on voice symptoms in patients with essential tremor.
• To assess whether DBS for hand tremor provides concurrent benefits for voice tremor.

Main Methods:

• Seven patients with essential tremor who had undergone DBS for hand tremor were studied.
• Voice tremor was evaluated with and without thalamic stimulation using patient and clinician severity ratings, and acoustic measures (rate and amplitude).
• Patients had received either unilateral or bilateral DBS implants.

Main Results:

• Four out of seven patients demonstrated reductions in voice symptoms with DBS.
• Improvements in voice tremor were observed in at least two evaluation measures for these patients.
• Observed voice gains were typically associated with more severe initial voice symptoms and did not directly correlate with upper extremity tremor improvement.

Conclusions:

• Deep brain stimulation of the ventral intermediate thalamic nucleus may offer a potential benefit for voice tremor in select essential tremor patients.
• Reduced voice tremor can be an additional, albeit not universal, advantage of DBS therapy for essential tremor.
• Further research is warranted to identify predictors for voice symptom improvement with DBS.