Response to Thalamic Ventralis Intermedius Nucleus Deep Brain Stimulation in Essential Tremor vs. Essential Tremor-Plus

Introduction: Essential tremor (ET) is a tremor syndrome characterized by bilateral, upper limb action tremor. Essential tremor-plus (ET-plus) describes ET patients with additional neurologic signs. It is unknown whether there is a difference in response to treatment with ventralis intermedius nucle...

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Autores principales:	Gabriela S. Gilmour, Davide Martino, Karen Hunka, Pia Lawrence, Zelma H. T. Kiss, Veronica Bruno
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	essential tremor tremor deep brain stimulation outcome predictors Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/52b9bb906cc94e22bb14d03319c8a07c
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spelling	oai:doaj.org-article:52b9bb906cc94e22bb14d03319c8a07c2021-12-01T13:07:06ZResponse to Thalamic Ventralis Intermedius Nucleus Deep Brain Stimulation in Essential Tremor vs. Essential Tremor-Plus1664-229510.3389/fneur.2021.790027https://doaj.org/article/52b9bb906cc94e22bb14d03319c8a07c2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.790027/fullhttps://doaj.org/toc/1664-2295Introduction: Essential tremor (ET) is a tremor syndrome characterized by bilateral, upper limb action tremor. Essential tremor-plus (ET-plus) describes ET patients with additional neurologic signs. It is unknown whether there is a difference in response to treatment with ventralis intermedius nucleus deep brain stimulation (VIM DBS) in patients with ET and ET-plus. Due to potential variability in underlying etiology in ET-plus, there is a concern that ET-plus patients may have worse outcomes. The aim of this study was to identify whether patients with ET-plus have worse tremor outcomes after VIM DBS than patients with ET.Methods: This is a retrospective chart and video review evaluating VIM DBS outcomes by comparing changes from baseline in the Fahn-Tolosa-Marin Tremor Rating Scale Part B (FTM-B) for the treated limb between patients with ET and ET-plus at follow-up examinations. Patients were re-classified as having ET or ET-plus using pre-operative examination videos by two independent movement disorders neurologists blinded to patient characteristics. As a secondary outcome, we evaluated for correlations and potential predictors of treatment response.Results: Twenty-six patients were included: 13 with ET, 13 with ET-plus. There were no significant differences in the change in FTM-B scores between the ET and ET-plus patients at each follow-up examination. None of the included patients developed new symptoms compatible with dystonia, parkinsonism or gait disturbances.Conclusions: Patients with ET-plus had tremor improvement from VIM DBS, with no differences when compared to those with ET, without emergence of postoperative neurological issues. Patients with ET-plus should still be considered good candidates for VIM DBS for treatment of tremor.Gabriela S. GilmourDavide MartinoDavide MartinoKaren HunkaPia LawrenceZelma H. T. KissZelma H. T. KissVeronica BrunoVeronica BrunoFrontiers Media S.A.articleessential tremortremordeep brain stimulationoutcomepredictorsNeurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	essential tremor tremor deep brain stimulation outcome predictors Neurology. Diseases of the nervous system RC346-429
spellingShingle	essential tremor tremor deep brain stimulation outcome predictors Neurology. Diseases of the nervous system RC346-429 Gabriela S. Gilmour Davide Martino Davide Martino Karen Hunka Pia Lawrence Zelma H. T. Kiss Zelma H. T. Kiss Veronica Bruno Veronica Bruno Response to Thalamic Ventralis Intermedius Nucleus Deep Brain Stimulation in Essential Tremor vs. Essential Tremor-Plus
description	Introduction: Essential tremor (ET) is a tremor syndrome characterized by bilateral, upper limb action tremor. Essential tremor-plus (ET-plus) describes ET patients with additional neurologic signs. It is unknown whether there is a difference in response to treatment with ventralis intermedius nucleus deep brain stimulation (VIM DBS) in patients with ET and ET-plus. Due to potential variability in underlying etiology in ET-plus, there is a concern that ET-plus patients may have worse outcomes. The aim of this study was to identify whether patients with ET-plus have worse tremor outcomes after VIM DBS than patients with ET.Methods: This is a retrospective chart and video review evaluating VIM DBS outcomes by comparing changes from baseline in the Fahn-Tolosa-Marin Tremor Rating Scale Part B (FTM-B) for the treated limb between patients with ET and ET-plus at follow-up examinations. Patients were re-classified as having ET or ET-plus using pre-operative examination videos by two independent movement disorders neurologists blinded to patient characteristics. As a secondary outcome, we evaluated for correlations and potential predictors of treatment response.Results: Twenty-six patients were included: 13 with ET, 13 with ET-plus. There were no significant differences in the change in FTM-B scores between the ET and ET-plus patients at each follow-up examination. None of the included patients developed new symptoms compatible with dystonia, parkinsonism or gait disturbances.Conclusions: Patients with ET-plus had tremor improvement from VIM DBS, with no differences when compared to those with ET, without emergence of postoperative neurological issues. Patients with ET-plus should still be considered good candidates for VIM DBS for treatment of tremor.
format	article
author	Gabriela S. Gilmour Davide Martino Davide Martino Karen Hunka Pia Lawrence Zelma H. T. Kiss Zelma H. T. Kiss Veronica Bruno Veronica Bruno
author_facet	Gabriela S. Gilmour Davide Martino Davide Martino Karen Hunka Pia Lawrence Zelma H. T. Kiss Zelma H. T. Kiss Veronica Bruno Veronica Bruno
author_sort	Gabriela S. Gilmour
title	Response to Thalamic Ventralis Intermedius Nucleus Deep Brain Stimulation in Essential Tremor vs. Essential Tremor-Plus
title_short	Response to Thalamic Ventralis Intermedius Nucleus Deep Brain Stimulation in Essential Tremor vs. Essential Tremor-Plus
title_full	Response to Thalamic Ventralis Intermedius Nucleus Deep Brain Stimulation in Essential Tremor vs. Essential Tremor-Plus
title_fullStr	Response to Thalamic Ventralis Intermedius Nucleus Deep Brain Stimulation in Essential Tremor vs. Essential Tremor-Plus
title_full_unstemmed	Response to Thalamic Ventralis Intermedius Nucleus Deep Brain Stimulation in Essential Tremor vs. Essential Tremor-Plus
title_sort	response to thalamic ventralis intermedius nucleus deep brain stimulation in essential tremor vs. essential tremor-plus
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/52b9bb906cc94e22bb14d03319c8a07c
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Response to Thalamic Ventralis Intermedius Nucleus Deep Brain Stimulation in Essential Tremor vs. Essential Tremor-Plus

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