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Long‐term efficacy of thalamic deep brain stimulation for tremor: Double‐blind assessments
Author(s) -
Rehncrona Stig,
Johnels Bo,
Widner Håkan,
Törnqvist AnnaLena,
Hariz Marwan,
Sydow Olof
Publication year - 2003
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.10309
Subject(s) - deep brain stimulation , essential tremor , stimulation , thalamus , parkinson's disease , thalamic stimulator , rating scale , medicine , central nervous system disease , psychology , neurological disorder , thalamotomy , anesthesia , neuroscience , physical medicine and rehabilitation , disease , developmental psychology
Thalamic deep brain stimulation (DBS) is proven to suppress tremor in Parkinson's disease (PD) and essential tremor (ET). However, there are few reports on its long‐term efficacy. We studied the efficacy of DBS at 2 years and 6–7 years after electrode implantations in the ventrointermediate nucleus of the thalamus in 39 patients (20 PD, 19 ET) with severe tremor. Twenty‐five of the patients completed the study. Evaluations were done in a double‐blind manner with the Unified Parkinson's Disease Rating Scale (UPDRS) and Essential Tremor Rating Scale (ETRS). DBS decreased tremor sum scores in PD ( P < 0.025) compared to the preoperative baseline (median, 7; Q25–75, 6–9) both at 2 years (median, 2; Q25–75, 2–3.5; n = 16) and at 6 to 7 years (median, 2.5; Q25–75, 0.5–3; n = 12). Stimulation on improved tremor sum as well as sub scores ( P < 0.025) compared to stimulation off conditions. In ET, thalamic stimulation improved ( P < 0.025) kinetic and positional tremor at both follow‐up periods (n = 18 and n = 13, respectively) with significant improvements ( P < 0.025) in hand‐function tests. PD but not ET patients showed a general disease progression. Stimulation parameters were remarkably stable over time. We conclude that high‐frequency electric thalamic stimulation can efficiently suppress severe tremor in PD and ET more than 6 years after permanent implantation of brain electrodes. © 2002 Movement Disorder Society