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Long term follow-up of deep brain stimulation of the caudal zona incerta for essential tremor.
J Neurol Neurosurg Psychiatry. 2012 Mar; 83(3):258-62.JN

Abstract

PURPOSE

The ventral intermediate nucleus of thalamus is the standard target for deep brain stimulation (DBS) in essential tremor (ET). However, favourable data have recently highlighted the caudal zona incerta (cZi) as an alternative target. Reports concerning the long-term results are however lacking, and we have therefore evaluated the long-term effects in our patients with ET and cZi DBS.

METHODS

18 patients were evaluated using the Essential Tremor Rating Scale (ETRS) before and on-/off-stimulation at 1 and 3-5 years after surgery (mean 48.5±10.6 months). Two patients were operated on bilaterally but all electrodes were evaluated separately. The stimulation parameters were recorded and the stimulation strength calculated.

RESULTS

A baseline total ETRS mean score of 46.0 decreased to 21.9 (52.4%) at the final evaluation. On the treated side, tremor of the upper extremity (item 5 or 6) improved from 6.1 to 0.5 (91.8%) and hand function (items 11-14) improved from 9.3 to 2.0 (78.0%). Activities of daily living improved by 65.8%. There was no increase in stimulation strength over time.

CONCLUSION

cZi DBS is a safe and effective treatment for the long term suppression of ET.

Authors+Show Affiliations

Department of Pharmacologyand Clinical Neuroscience, Section of Neurosurgery, Umeå University, Umeå, Sweden. anders.fytagoridis@neuro.umu.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

22205676

Citation

Fytagoridis, Anders, et al. "Long Term Follow-up of Deep Brain Stimulation of the Caudal Zona Incerta for Essential Tremor." Journal of Neurology, Neurosurgery, and Psychiatry, vol. 83, no. 3, 2012, pp. 258-62.
Fytagoridis A, Sandvik U, Aström M, et al. Long term follow-up of deep brain stimulation of the caudal zona incerta for essential tremor. J Neurol Neurosurg Psychiatry. 2012;83(3):258-62.
Fytagoridis, A., Sandvik, U., Aström, M., Bergenheim, T., & Blomstedt, P. (2012). Long term follow-up of deep brain stimulation of the caudal zona incerta for essential tremor. Journal of Neurology, Neurosurgery, and Psychiatry, 83(3), 258-62. https://doi.org/10.1136/jnnp-2011-300765
Fytagoridis A, et al. Long Term Follow-up of Deep Brain Stimulation of the Caudal Zona Incerta for Essential Tremor. J Neurol Neurosurg Psychiatry. 2012;83(3):258-62. PubMed PMID: 22205676.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long term follow-up of deep brain stimulation of the caudal zona incerta for essential tremor. AU - Fytagoridis,Anders, AU - Sandvik,Ulrika, AU - Aström,Mattias, AU - Bergenheim,Tommy, AU - Blomstedt,Patric, Y1 - 2011/12/28/ PY - 2011/12/30/entrez PY - 2011/12/30/pubmed PY - 2012/3/29/medline SP - 258 EP - 62 JF - Journal of neurology, neurosurgery, and psychiatry JO - J Neurol Neurosurg Psychiatry VL - 83 IS - 3 N2 - PURPOSE: The ventral intermediate nucleus of thalamus is the standard target for deep brain stimulation (DBS) in essential tremor (ET). However, favourable data have recently highlighted the caudal zona incerta (cZi) as an alternative target. Reports concerning the long-term results are however lacking, and we have therefore evaluated the long-term effects in our patients with ET and cZi DBS. METHODS: 18 patients were evaluated using the Essential Tremor Rating Scale (ETRS) before and on-/off-stimulation at 1 and 3-5 years after surgery (mean 48.5±10.6 months). Two patients were operated on bilaterally but all electrodes were evaluated separately. The stimulation parameters were recorded and the stimulation strength calculated. RESULTS: A baseline total ETRS mean score of 46.0 decreased to 21.9 (52.4%) at the final evaluation. On the treated side, tremor of the upper extremity (item 5 or 6) improved from 6.1 to 0.5 (91.8%) and hand function (items 11-14) improved from 9.3 to 2.0 (78.0%). Activities of daily living improved by 65.8%. There was no increase in stimulation strength over time. CONCLUSION: cZi DBS is a safe and effective treatment for the long term suppression of ET. SN - 1468-330X UR - https://www.unboundmedicine.com/medline/citation/22205676/Long_term_follow_up_of_deep_brain_stimulation_of_the_caudal_zona_incerta_for_essential_tremor_ L2 - https://jnnp.bmj.com/lookup/pmidlookup?view=long&pmid=22205676 DB - PRIME DP - Unbound Medicine ER -