Deep brain stimulation for lesion-related tremors: A systematic review and meta-analysis

Mendonça, Marcelo; Meira, Bruna; Fernandes, Marco; Barbosa, Raquel; Bugalho, Paulo

doi:10.1016/j.parkreldis.2017.12.014

Cited by 21 publications

(28 citation statements)

References 46 publications

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“…Otherwise, a fixed effects model was used. The primary outcome was improvement, which was calculated as a percentage of change in any objective TRS scores [16], and the safety of DBS for ET was evaluated mainly based on adverse events of particular interest, such as dysarthria, paresthesia, hemiparesis/paresis, and headache.…”

Section: Discussionmentioning

confidence: 99%

Outcomes and Adverse Effects of Deep Brain Stimulation on the Ventral Intermediate Nucleus in Patients with Essential Tremor

Luo

Liu

et al. 2020

Neural Plasticity

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Objective. This study was aimed at identifying the potential outcome predictors, comparing the efficacy in patients with different tremor characteristics, and summarizing the adverse effect rates (AERs) of deep brain stimulation on the ventral intermediate nucleus (VIM-DBS) for essential tremor (ET). Methods. An extensive search of articles published to date in 2019 was conducted, and two main aspects were analyzed. Improvement was calculated as a percentage of change in any objective tremor rating scale (TRS) and analyzed by subgroup analyses of patients’ tremor characteristics, laterality, and stimulation parameters. Furthermore, the AERs were analyzed as follows: the adverse effects (AEs) were classified as stimulation-related, surgical-related, or device-related effects. A simple regression analysis was used to identify the potential prognostic factors, and a two-sample mean-comparison test was used to verify the statistical significance of the subgroup analyses. Results. Forty-six articles involving 1714 patients were included in the meta-analysis. The pooled improvement in any objective TRS score was 61.3% (95% CI: 0.564-0.660) at the mean follow-up visit (20.0±17.3 months). The midline and extremity symptoms showed consistent improvement (P=0.440), and the results of the comparison of postural and kinetic tremor were the same (P=0.219). In addition, the improvement in rest tremor was similar to that in action tremor (OR=2.759, P=0.120). In the simple regression analysis, the preoperative Fahn-Tolosa-Marin Tremor Rating Scale (FTM-TRS) scores and follow-up time were negatively correlated with the percentage change in any objective TRS score (P<0.05). The most common adverse event was dysarthria (10.5%), which is a stimulation-related AE (23.6%), while the rates of the surgical-related and device-related AEs were 6.4% and 11.5%, respectively. Conclusion. VIM-DBS is an efficient and safe surgical method in ET, and the efficacy was not affected by the body distribution of tremor, age at surgery, and disease duration. Lower preoperative FTM-TRS scores likely indicate greater improvement, and the effect of VIM-DBS declines over time.

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Section: Discussionmentioning

confidence: 99%

Outcomes and Adverse Effects of Deep Brain Stimulation on the Ventral Intermediate Nucleus in Patients with Essential Tremor

Luo

Liu

et al. 2020

Neural Plasticity

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“…DBS has been used in a variety of rarer indications, including post-stroke tremors, lesion-related tremors and post-traumatic tremors. Many of these cases also fulfill the criteria for Holmes tremor, which consists of a slow (usually <5 Hz) rest, postural and intention tremor typically appearing up to 2 years following central nervous system injury [1,96]. The literature on these syndromes is limited to small case reports and case series providing anecdotal evidence of efficacy.…”

Section: Other Tremorsmentioning

confidence: 99%

“…The literature on these syndromes is limited to small case reports and case series providing anecdotal evidence of efficacy. In a recent meta-analysis of 35 studies reporting 82 patients, Vim DBS was performed in 63.6% of cases, GPi in 18.2% and other targets (PSA and Vo) in the remaining cases [96]. Median tremor improvement was 75%, although a significant publication bias might be present.…”

Section: Other Tremorsmentioning

confidence: 99%

Deep-Brain Stimulation for Essential Tremor and Other Tremor Syndromes: A Narrative Review of Current Targets and Clinical Outcomes

2020

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Tremor is a prevalent symptom associated with multiple conditions, including essential tremor (ET), Parkinson’s disease (PD), multiple sclerosis (MS), stroke and trauma. The surgical management of tremor evolved from stereotactic lesions to deep-brain stimulation (DBS), which allowed safe and reversible interference with specific neural networks. This paper reviews the current literature on DBS for tremor, starting with a detailed discussion of current tremor targets (ventral intermediate nucleus of the thalamus (Vim), prelemniscal radiations (Raprl), caudal zona incerta (Zi), thalamus (Vo) and subthalamic nucleus (STN)) and continuing with a discussion of results obtained when performing DBS in the various aforementioned tremor syndromes. Future directions for DBS research are then briefly discussed.

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“…DBS has been used in a variety of rarer indications, including post-stroke tremors, lesion-related tremors and post-traumatic tremors. Many of these cases also fulfill the criteria for Holmes tremor, which consists of a slow (usually < 5 Hz) rest, postural and intention tremor typically appearing up to 2 years following CNS injury [1,73]. The literature on these syndromes is limited to small case reports and case series providing anecdotal evidence of efficacy.…”

Section: Other Tremorsmentioning

confidence: 99%

Section: Other Tremorsmentioning

confidence: 99%

Deep Brain Stimulation for Essential Tremor and Other Tremor Syndromes: A Narrative Review of Current Targets and Clinical Outcomes

Iorio-Morin

Fomenko

Kalia

2020

Preprint

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Tremor is a prevalent symptom associated with multiple conditions, including Essential Tremor (ET), Parkinson’s disease (PD), multiple sclerosis (MS), stroke, and trauma. The surgical management of tremor evolved from stereotactic lesions to deep-brain stimulation (DBS), which allowed safe and reversible interference with specific neural networks. This paper reviews the current literature on DBS for tremor, starting with a detailed discussion of current tremor targets (Vim, Raprl, caudal Zi, Vo and STN) and continuing with a discussion of results obtained when performing DBS in the various aforementioned tremor syndromes. Future directions for DBS research are then briefly discussed.

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Deep brain stimulation for lesion-related tremors: A systematic review and meta-analysis

Cited by 21 publications

References 46 publications

Outcomes and Adverse Effects of Deep Brain Stimulation on the Ventral Intermediate Nucleus in Patients with Essential Tremor

Outcomes and Adverse Effects of Deep Brain Stimulation on the Ventral Intermediate Nucleus in Patients with Essential Tremor

Deep-Brain Stimulation for Essential Tremor and Other Tremor Syndromes: A Narrative Review of Current Targets and Clinical Outcomes

Deep Brain Stimulation for Essential Tremor and Other Tremor Syndromes: A Narrative Review of Current Targets and Clinical Outcomes

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