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Clin Neurophysiol. 2020 Jan;131(1):167-176. doi: 10.1016/j.clinph.2019.10.019. Epub 2019 Nov 20.

Effects of ventral intermediate nucleus deep brain stimulation across multiple effectors in essential tremor.

Author information

1
Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA.
2
Department of Neurology, Fixel Institute for Neurological Diseases, Movement Disorders and Neurorestoration Program, University of Florida, Gainesville, FL, USA.
3
Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA; Department of Neurology, Fixel Institute for Neurological Diseases, Movement Disorders and Neurorestoration Program, University of Florida, Gainesville, FL, USA; Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA. Electronic address: vcourt@ufl.edu.

Abstract

OBJECTIVE:

Essential tremor (ET) prominently affects the upper-limbs during voluntary movements, but can also affect the lower-limbs, head, and chin. Although deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) of thalamus improves both clinical ratings and quantitative measures of tremor, no study has quantified effects of DBS on tremor across multiple body parts. Our objective was to quantify therapeutic effects of DBS across multiple body parts in ET.

METHODS:

We performed quantitative assessment of tremor in ET patients who had DBS for at least one year. We assessed tremor on and off VIM-stimulation using triaxial accelerometers on the upper-limbs, lower-limbs, head and chin during seated and standing tasks.

RESULTS:

VIM-DBS significantly reduced tremor, but there was no statistical difference in degree of tremor reduction across the measured effectors. Compared to healthy controls, ET patients treated with DBS showed significantly greater tremor power (4-8 Hz) across all effectors during seated and standing tasks.

CONCLUSIONS:

VIM-DBS reduced tremor in ET patients. There was no significant difference in the degree of tremor reduction across the measured effectors.

SIGNIFICANCE:

This study provides new quantitative evidence that VIM-DBS is effective at reducing tremor across multiple parts of the body.

KEYWORDS:

Accelerometer; Deep brain stimulation; Essential tremor; Thalamus

PMID:
31794958
PMCID:
PMC6920570
[Available on 2021-01-01]
DOI:
10.1016/j.clinph.2019.10.019

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