Sun X, Huang L, Pan Y, Zhang C, Wang T, Li H, Sun B, Ding J, Wu Y, Li D. Bilateral Posterior Subthalamic Area Deep Brain Stimulation for Essential Tremor: A Case Series.
Front Hum Neurosci 2020;
14:16. [PMID:
32116604 PMCID:
PMC7013085 DOI:
10.3389/fnhum.2020.00016]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 01/16/2020] [Indexed: 11/16/2022] Open
Abstract
Background
Deep brain stimulation (DBS) of the posterior subthalamic area (PSA) provides a potentially effective treatment for medication-refractory essential tremor (ET).
Objective
To study the clinical benefits and adverse-event profile of bilateral PSA-DBS for refractory ET.
Methods
Seven patients with refractory ET underwent bilateral PSA-DBS surgery under general anesthesia between September 2017 and May 2018. Clinical outcome assessments, using the Essential Tremor Rating Scale, were performed at 1-, 6-, and 12-month follow-up, except for the last assessment of one patient who was followed up to 9 months. Analysis was focused on changes in patients’ motor symptoms and quality of life following surgery as well as documenting the adverse-event profile associated with the surgical PSA-DBS treatment.
Results
After surgery, patients’ motor symptoms, including upper limb tremor and head tremor, were improved by 84.2% and their quality of life by 81.25% at 1-month follow-up. The clinical benefits to patients were maintained at 6-month and last follow-up. Adverse side effects included dysarthria (n = 4), balance disorder (n = 2), and paresthesia of the right limb (n = 1). No habituation effects were observed throughout the follow-up.
Conclusion
Bilateral PSA-DBS seems to offer an effective and safe alternative treatment for medically intractable ET, warranting further research into its clinical utility, adverse-event profile, and comparative effectiveness.
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