Barbe, Michael T., Reker, Paul, Hamacher, Stefanie ORCID: 0000-0003-2158-9101, Franklin, Jeremy ORCID: 0000-0003-1536-0925, Kraus, Daria, Dembek, Till A., Becker, Johannes, Steffen, Julia K., Allert, Niels, Wirths, Jochen, Dafsari, Haidar S., Voges, Juergen, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Visser-Vandewalle, Veerle and Timmermann, Lars (2018). DBS of the PSA and the VIM in essential tremor A randomized, double-blind, crossover trial. Neurology, 91 (6). S. E543 - 8. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1526-632X

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Abstract

Objective To evaluate deep brain stimulation (DBS) of the posterior subthalamic area (PSA) in essential tremor (ET) and compare it to the ventral intermediate nucleus of the thalamus (VIM) in terms of stimulation efficacy, efficiency, and side effects. Methods DBS leads were implanted such that contacts were placed in the VIM, on the intercommissural line, and in the PSA. Thirteen patients with ET entered a randomized, double-blind crossover phase and completed a 1-year follow-up. Results PSA-DBS significantly reduced tremor severity and improved quality of life. There were no relevant differences in quality and frequency of stimulation side effects between VIM and PSA, with a tendency toward greater tremor improvement with PSA stimulation. Clinical benefit was achieved at significantly lower stimulation amplitudes in the PSA. The majority of patients remained with PSA-DBS after 1 year. Conclusion In accordance with previous retrospective investigations, our prospective data suggest that PSA-DBS is at least equally effective as but possibly more efficient than VIM-DBS. Classification of evidence This study provides Class I evidence that for patients with essential tremor, PSA-DBS is not significantly different from VIM-DBS in suppressing tremor, but clinical benefit from PSA-DBS is attained at lower stimulation amplitudes.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Barbe, Michael T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reker, PaulUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hamacher, StefanieUNSPECIFIEDorcid.org/0000-0003-2158-9101UNSPECIFIED
Franklin, JeremyUNSPECIFIEDorcid.org/0000-0003-1536-0925UNSPECIFIED
Kraus, DariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dembek, Till A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Becker, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steffen, Julia K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Allert, NielsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wirths, JochenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dafsari, Haidar S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Voges, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fink, Gereon R.UNSPECIFIEDorcid.org/0000-0002-8230-1856UNSPECIFIED
Visser-Vandewalle, VeerleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Timmermann, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-176615
DOI: 10.1212/WNL.0000000000005956
Journal or Publication Title: Neurology
Volume: 91
Number: 6
Page Range: S. E543 - 8
Date: 2018
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1526-632X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
DEEP BRAIN-STIMULATION; POSTERIOR SUBTHALAMIC AREA; THALAMIC-STIMULATION; INTENTION TREMOR; RATING-SCALE; NUCLEUS; NEUROSTIMULATION; COMPLICATIONS; QUESTIONNAIRE; ELECTRODEMultiple languages
Clinical NeurologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/17661

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