Loss of benefit in VIM thalamic deep brain stimulation (DBS) for essential tremor (ET): How prevalent is it?

Shih, Ludy C.; LaFaver, Kathrin; Lim, Chen; Papavassiliou, Efstathios; Tarsy, Daniel

doi:10.1016/j.parkreldis.2013.03.006

Cited by 95 publications

(76 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With the advent of new directional electrodes that are capable of interleaving stimulation it is possible to reduce the stimulation induced side effects [41]. Although Vim DBS is effective in tremor control, recent retrospective studies have reported a loss of benefit in as high as 70% of the patients which is possibly related with tremor progression rather than stimulation tolerance [42,43].…”

Section: Disease; Kinetic Tremormentioning

confidence: 99%

Recent Advances in Essential Tremor

Goksemin¹

2016

J Mult Scler

View full text Add to dashboard Cite

Essential tremor (ET) is the most prevalent tremor disorder. It is characterized by 8-12 Hz action tremor of the arms; head tremor and other cranial tremors may also occur, as well as limb and gait ataxia and subtle eye motion abnormalities [1][2][3][4][5]. The prevalence and incidence increase with age, so that more than 20% of individuals over 90 years have ET [1,6].In recent year's neuroepidemiological, clinical and pathological studies have substantially contributed to the changing of view of ET. The traditional view of ET as a monosymptomatic condition is being replaced by an appreciation of the spectrum of clinical features and clinical associations, with both motor and non-motor features [7][8][9][10][11]. It is even possible that ET might be a family of diseases, unified by the presence of kinetic tremor, but further characterized by etiological, clinical and pathological heterogeneity [10].Both genetic and environmental factors play a role in ET, but the underlying causes are far from fully elaborated. Recent studies have reported a genome-wide significant association between leucinerich repeat and Ig domain containing 1 gene (LINGO1) and risk for essential tremor [12][13][14][15]. Further studies also confirmed this finding in populations of European and Asian descent, showing LINGO1 is likely a risk factor for essential tremor with widespread distribution [14,15]. Parkinson's disease (PD) and ET are regarded as distinct entities, but clinical evidence suggest that there is a considerable overlap. For instance, in some cases action tremor can precede the onset of PD symptoms and there is a fourfold increased risk of developing PD in patients with ET [16]. Moreover, in a number of ET cases Lewy bodies have been identified in the brain stem and imaging studies have found signs of dopaminergic deficits in some patients with ET [17]. Given these overlapping features and the association of LINGO 1 with ET, VillarinoGuell et al. [14] investigated the role of LINGO1 in PD and their results revealed an association between LINGO1 and risk of PD. Although these results are not confirmed by other reports, further studies of larger populations are required to investigate the role of LINGO1 in PD [18]. From the pathophysiological perspective, traditionally ET is considered as a primary electrical/elctrophysiological entitiy. It is the result of pacemaking neurons in the inferior olivary nucleus that fire in a coupled manner, and produce tremor through an abnormal olivocerebellar output. But this olivary model of ET suffers from a number of critical problems, such as lack of evidence that this process is occurring in human ET as well. Another major problem of this model is that there are numerous pacemakers in the central nervous system which are also connected with the cerebellum [19][20][21]. Therefore, olivary pacemakers are not unique. Moreover, the main empiric support of olivary model comes from the harmaline model which is not a model of human disease [22]. Over the past decade an alternative model, cerebella...

show abstract

Section: Disease; Kinetic Tremormentioning

confidence: 99%

Recent Advances in Essential Tremor

Goksemin¹

2016

J Mult Scler

View full text Add to dashboard Cite

show abstract

“…Between 13 and 40% of patients experience tremor worsening following VIM-DBS, and the wide range reflects the varied definitions and metrics for failure in the studies reviewed [2]. In one center, a cohort of 45 patients was followed longitudinally for a mean of 55.9 months; 73% experienced declining efficacy, defined operationally as the need for recurrent programming attempts after at least 3 months of satisfactory tremor attenuation after implantation [4]. Interestingly, none of the clinical features assessed in that particular study (e.g., age at implantation, disease duration, tremor severity, etc.)…”

Section: Introductionmentioning

confidence: 99%

“…Interestingly, none of the clinical features assessed in that particular study (e.g., age at implantation, disease duration, tremor severity, etc.) correlated with waning of the DBS benefit [4]. …”

Section: Introductionmentioning

confidence: 99%

Confined Thalamic Deep Brain Stimulation in Refractory Essential Tremor

Isaacs

Butler

Sukul

et al. 2018

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

Background: Thalamic ventral intermediate nucleus (VIM) deep brain stimulation (DBS) is an effective therapy for medication-refractory essential tremor (ET). However, 13–40% of patients with an initially robust tremor efficacy lose this benefit over time despite reprogramming attempts. At our institution, a cohort of ET patients with VIM DBS underwent implantation of a second anterior (ventralis oralis anterior; VOA) DBS lead to permit “confined stimulation.” We sought to assess whether confined stimulation conferred additional tremor capture compared to VIM or VOA stimulation alone. Methods: Seven patients participated in a protocol-based programming session during which a video-recorded Fahn-Tolosa-Marin Part A (FTM-A) tremor rating scale was used in the following 4 DBS states: off stimulation, VIM stimulation alone, VOA stimulation alone, and dual lead (confined) stimulation. Results: The average (SD) baseline FTM-A off score was 17.6 (4.0). VIM stimulation alone lowered the average FTM-A total score to 6.9 (4.0). Confined stimulation further attenuated the tremor, reducing the total score to 5.7 (2.8). Conclusions: Confined thalamic DBS can provide additional symptomatic benefits in patients with unsatisfactory tremor control from VIM or VOA stimulation alone.

show abstract

“…In einzelnen Studien nahmen die Skalenwerte zu den Aktivitäten des täglichen Lebens wieder auf das Niveau vor der Operation ab. Eine Reihe von Studien berichtet über eine Abnahme des Stimulationseffekts beim essenziellen Tremor nach Monaten oder Jahren -und damit über die Dauer eines möglichen Setzeffekts hinausbei zumindest einem Teil der Patienten[1,8,23]. Dadurch bedingt mussten Stimulationsparameter z. T. im Verlauf nach oben angepasst werden.…”

unclassified

“…Dabei schien in vielen Fällen eine Progression des Tremors, die bei nichtoperierten Kontrollen in ähnlichem Ausmaß beobachtet werden konnte, eine stärkere Rolle zu spielen als eine Habituation des Therapieeffekts[8]. Mögliche, noch unbestätigte Risikofaktoren einer Verschlechterung könnten einseitige Tremorausprägung und weibliches Geschlecht, offenbar jedoch nicht das Alter sein[8,23]. In anderen Serien…”

unclassified