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Tremor Other Hyperkinet Mov (N Y). 2019 Mar 29;9:621. doi: 10.7916/d8-8vww-td18. eCollection 2019.

Segmented versus Nonsegmented Deep-Brain Stimulation for Essential Tremor Differ in Ataxic Side Effects.

Author information

University of North Carolina at Chapel Hill, North Carolina, US.



Directional, deep-brain stimulation may prove beneficial for targets (1) thinner along the lead trajectory, and (2) whose borders are not easily visible by neuroimaging. When targeting the ventral intermediate (VIM) nucleus of the thalamus for essential tremor, even baseline ataxia may be exacerbated by medial spread of current and antidromic stimulation of vestibular-cerebellar-thalamic afferents.

Case Report:

The present patient with essential tremor developed refractory head tremor leading to implantation of bilateral St. Jude/Abbott segmented leads into the VIM to afford additional programming options.


Video evidence showed that directional stimulation did not exacerbate ataxia beyond baseline, whereas nondirectional stimulation exacerbated ataxia consistently. We discuss how this programming advantage may help address a common complication from DBS implantation for essential tremor patients.


DBS; ataxia; essential tremor; head tremor; segment

[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Funding: No specific funding was received for this work. Conflicts of Interest: The author reports no conflict of interest. Ethics Statement: This study was reviewed by the authors' institutional ethics committee and was considered exempted from further review.

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