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Bilateral caudal zona incerta nucleus stimulation for essential tremor: outcome and quality of life.
J Neurol Neurosurg Psychiatry. 2011 Aug; 82(8):899-904.JN

Abstract

BACKGROUND

Over the past few years, bilateral stimulation of the caudal or motor part of the zona incerta nucleus (cZI) has been performed by the authors in patients with essential tremor (ET). Outcomes including quality of life data in 15 patients with a follow-up period of up to 84 months (mean 31.7 ± 28.6 months) are presented.

METHODS

15 consecutive ET patients underwent MRI guided bilateral cZI deep brain stimulation implantation. Patients were assessed by applying the Fahn-Tolosa-Marin Tremor Rating Scale and the Short Form Health Survey-36 (SF-36) to assess quality of life.

RESULTS

The total tremor score improved by 73.8% (p<0.0001). The part A score (items 1-9) improved by 86.6% (p<0.0001). Postural tremor improved by 88.2% (p<0.0001) and action tremor by 82.2% (p<0.0001). The part B score, which evaluates the functional activities of the upper limbs, improved by 60.1% (p<0.0001). Part C score, which evaluates the activities of daily living, improved by 80.0% (p<0.0001). The SF-36 physical component score improved by 23.7% (p<0.0001) and the mental component score by 22.4% (p<0.0001). There was one wound infection and three patients developed stimulation related transient dysarthria. None developed any disequilibrium or tolerance to stimulation.

CONCLUSION

Bilateral cZI stimulation is safe and effective in suppressing the postural and action component of ET. It is associated with a low incidence of stimulation related complications and patients do not develop tolerance to stimulation with maintained clinical benefit over a follow-up period of up to 7 years.

Authors+Show Affiliations

Department of Neurosurgery, Frenchay Hospital, Bristol BS16 1LE, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21285454

Citation

Plaha, Puneet, et al. "Bilateral Caudal Zona Incerta Nucleus Stimulation for Essential Tremor: Outcome and Quality of Life." Journal of Neurology, Neurosurgery, and Psychiatry, vol. 82, no. 8, 2011, pp. 899-904.
Plaha P, Javed S, Agombar D, et al. Bilateral caudal zona incerta nucleus stimulation for essential tremor: outcome and quality of life. J Neurol Neurosurg Psychiatry. 2011;82(8):899-904.
Plaha, P., Javed, S., Agombar, D., O' Farrell, G., Khan, S., Whone, A., & Gill, S. (2011). Bilateral caudal zona incerta nucleus stimulation for essential tremor: outcome and quality of life. Journal of Neurology, Neurosurgery, and Psychiatry, 82(8), 899-904. https://doi.org/10.1136/jnnp.2010.222992
Plaha P, et al. Bilateral Caudal Zona Incerta Nucleus Stimulation for Essential Tremor: Outcome and Quality of Life. J Neurol Neurosurg Psychiatry. 2011;82(8):899-904. PubMed PMID: 21285454.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bilateral caudal zona incerta nucleus stimulation for essential tremor: outcome and quality of life. AU - Plaha,Puneet, AU - Javed,Shazia, AU - Agombar,David, AU - O' Farrell,Genevive, AU - Khan,Sadaquate, AU - Whone,Alan, AU - Gill,Steven, Y1 - 2011/02/01/ PY - 2011/2/3/entrez PY - 2011/2/3/pubmed PY - 2011/10/5/medline SP - 899 EP - 904 JF - Journal of neurology, neurosurgery, and psychiatry JO - J Neurol Neurosurg Psychiatry VL - 82 IS - 8 N2 - BACKGROUND: Over the past few years, bilateral stimulation of the caudal or motor part of the zona incerta nucleus (cZI) has been performed by the authors in patients with essential tremor (ET). Outcomes including quality of life data in 15 patients with a follow-up period of up to 84 months (mean 31.7 ± 28.6 months) are presented. METHODS: 15 consecutive ET patients underwent MRI guided bilateral cZI deep brain stimulation implantation. Patients were assessed by applying the Fahn-Tolosa-Marin Tremor Rating Scale and the Short Form Health Survey-36 (SF-36) to assess quality of life. RESULTS: The total tremor score improved by 73.8% (p<0.0001). The part A score (items 1-9) improved by 86.6% (p<0.0001). Postural tremor improved by 88.2% (p<0.0001) and action tremor by 82.2% (p<0.0001). The part B score, which evaluates the functional activities of the upper limbs, improved by 60.1% (p<0.0001). Part C score, which evaluates the activities of daily living, improved by 80.0% (p<0.0001). The SF-36 physical component score improved by 23.7% (p<0.0001) and the mental component score by 22.4% (p<0.0001). There was one wound infection and three patients developed stimulation related transient dysarthria. None developed any disequilibrium or tolerance to stimulation. CONCLUSION: Bilateral cZI stimulation is safe and effective in suppressing the postural and action component of ET. It is associated with a low incidence of stimulation related complications and patients do not develop tolerance to stimulation with maintained clinical benefit over a follow-up period of up to 7 years. SN - 1468-330X UR - https://www.unboundmedicine.com/medline/citation/21285454/Bilateral_caudal_zona_incerta_nucleus_stimulation_for_essential_tremor:_outcome_and_quality_of_life_ L2 - https://jnnp.bmj.com/lookup/pmidlookup?view=long&amp;pmid=21285454 DB - PRIME DP - Unbound Medicine ER -