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Voice Tremor in Patients with Essential Tremor: Effects of Deep Brain Stimulation of Caudal Zona Incerta.
J Voice. 2016 Mar; 30(2):228-33.JV

Abstract

OBJECTIVES

The present study aimed at evaluating the effect of deep brain stimulation (DBS) of the caudal zona incerta (cZi) on voice tremor in patients with essential tremor (ET).

STUDY DESIGN

This is a prospective nonrandomized design with consecutive patients.

METHODS

Twenty-six patients operated with cZi DBS were evaluated under two conditions: without stimulation (Stim OFF) and with stimulation (Stim ON). Voice tremor was assessed on the basis of recordings of sustained vowel productions using a four-point rating scale in a blinded and randomized procedure. Averaged values of multiple assessments for each stimulus were used in statistical testing. The group of patients with voice tremor in Stim OFF was analyzed separately from the group of patients without voice tremor.

RESULTS

Voice tremor was significantly reduced on stimulation compared with off for the subgroup with initial voice tremor. Voice tremor prevalence was found to be 50% (13 patients). Individual differences in voice tremor outcome were noticeable. Six of the patients with voice tremor at baseline improved substantially by cZi DBS treatment.

CONCLUSIONS

On the group level, voice tremor in patients with ET was found to reduce when stimulating the cZi. Bilateral stimulation was indicated to be more effective in reducing voice tremor than unilateral stimulation. However, individual voice tremor outcomes suggest that not all patients benefit from cZi DBS. Severity of voice tremor at baseline may not be a good predictor of voice tremor outcome after cZi DBS. Patients should be informed before surgery regarding individual differences in response to DBS treatment.

Authors+Show Affiliations

Department of Clinical Sciences, Umeå University, Umeå, Sweden.Department of Clinical Sciences, Umeå University, Umeå, Sweden.Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden.Department of Clinical Sciences, Umeå University, Umeå, Sweden. Electronic address: fredrik.k.karlsson@umu.se.

Pub Type(s)

Clinical Study
Journal Article

Language

eng

PubMed ID

26001501

Citation

Hägglund, Patricia, et al. "Voice Tremor in Patients With Essential Tremor: Effects of Deep Brain Stimulation of Caudal Zona Incerta." Journal of Voice : Official Journal of the Voice Foundation, vol. 30, no. 2, 2016, pp. 228-33.
Hägglund P, Sandström L, Blomstedt P, et al. Voice Tremor in Patients with Essential Tremor: Effects of Deep Brain Stimulation of Caudal Zona Incerta. J Voice. 2016;30(2):228-33.
Hägglund, P., Sandström, L., Blomstedt, P., & Karlsson, F. (2016). Voice Tremor in Patients with Essential Tremor: Effects of Deep Brain Stimulation of Caudal Zona Incerta. Journal of Voice : Official Journal of the Voice Foundation, 30(2), 228-33. https://doi.org/10.1016/j.jvoice.2015.04.003
Hägglund P, et al. Voice Tremor in Patients With Essential Tremor: Effects of Deep Brain Stimulation of Caudal Zona Incerta. J Voice. 2016;30(2):228-33. PubMed PMID: 26001501.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Voice Tremor in Patients with Essential Tremor: Effects of Deep Brain Stimulation of Caudal Zona Incerta. AU - Hägglund,Patricia, AU - Sandström,Linda, AU - Blomstedt,Patric, AU - Karlsson,Fredrik, Y1 - 2015/05/20/ PY - 2015/02/25/received PY - 2015/04/02/accepted PY - 2015/5/24/entrez PY - 2015/5/24/pubmed PY - 2016/12/15/medline KW - DBS KW - Essential tremor KW - Perceptual evaluation KW - Voice tremor KW - cZi SP - 228 EP - 33 JF - Journal of voice : official journal of the Voice Foundation JO - J Voice VL - 30 IS - 2 N2 - OBJECTIVES: The present study aimed at evaluating the effect of deep brain stimulation (DBS) of the caudal zona incerta (cZi) on voice tremor in patients with essential tremor (ET). STUDY DESIGN: This is a prospective nonrandomized design with consecutive patients. METHODS: Twenty-six patients operated with cZi DBS were evaluated under two conditions: without stimulation (Stim OFF) and with stimulation (Stim ON). Voice tremor was assessed on the basis of recordings of sustained vowel productions using a four-point rating scale in a blinded and randomized procedure. Averaged values of multiple assessments for each stimulus were used in statistical testing. The group of patients with voice tremor in Stim OFF was analyzed separately from the group of patients without voice tremor. RESULTS: Voice tremor was significantly reduced on stimulation compared with off for the subgroup with initial voice tremor. Voice tremor prevalence was found to be 50% (13 patients). Individual differences in voice tremor outcome were noticeable. Six of the patients with voice tremor at baseline improved substantially by cZi DBS treatment. CONCLUSIONS: On the group level, voice tremor in patients with ET was found to reduce when stimulating the cZi. Bilateral stimulation was indicated to be more effective in reducing voice tremor than unilateral stimulation. However, individual voice tremor outcomes suggest that not all patients benefit from cZi DBS. Severity of voice tremor at baseline may not be a good predictor of voice tremor outcome after cZi DBS. Patients should be informed before surgery regarding individual differences in response to DBS treatment. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/26001501/Voice_Tremor_in_Patients_with_Essential_Tremor:_Effects_of_Deep_Brain_Stimulation_of_Caudal_Zona_Incerta_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(15)00063-6 DB - PRIME DP - Unbound Medicine ER -