Simultaneous Thalamic and Posterior Subthalamic Electrode Insertion With Single Deep Brain Stimulation Electrode for Essential Tremor

Chang, Won Seok; Chung, Jong Chul; Kim, Joo Pyung; Chang, Jin Woo

doi:10.1111/j.1525-1403.2012.00503.x

Cited by 22 publications

(24 citation statements)

References 34 publications

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“…TETRAS performance scores correlated well with transducer measures of tremor and with the TETRAS ADL subscale . Good test‐retest reliability and sensitivity to change have been demonstrated for upper limb postural and kinetic ET …”

Section: Resultsmentioning

confidence: 78%

Task force report: Scales for screening and evaluating tremor: Critique and recommendations

et al. 2013

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The Movement Disorder Society established a task force to review rating scales for the assessment of tremor. Screening instruments used in identifying patients with tremor were also reviewed. Seven tremor severity scales, six activities of daily living (ADL)/disability scales, four quality-of-life scales, and five screening instruments were identified by searching PubMed.gov. The availability, use, acceptability, reliability, validity, and sensitivity to change were reviewed for each scale; and each scale was classified as recommended, suggested or listed based on whether 3, 2, or 1 of the following criteria were met: (1) used in the assessment of tremor (yes/no), (2) used in published studies by people other than the developers (yes/no), and (3) successful clinimetric testing (yes/no). Five tremor severity scales (the Fahn-Tolosa-Marin Tremor Rating Scale, the Bain and Findley Clinical Tremor Rating Scale, the Bain and Findley Spirography Scale, the Washington Heights-Inwood Genetic Study of Essential Tremor Rating Scale, and the Tremor Research Group Essential Tremor Rating Assessment Scale), one ADL/disability scale (the Bain and Findley Tremor ADL Scale), one quality-of-life scale (the Quality of Life in Essential Tremor Questionnaire), and one screening instrument (the Washington Heights-Inwood Genetic Study of Essential Tremor Rating Scale, version 1) are recommended using these criteria. However, all scales need a more comprehensive analysis of sensitivity to change in order to judge their utility in clinical trials and individual patient assessments. The task force recommends that further work with existing recommended scales be performed as opposed to the development of new tremor scales.

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Section: Resultsmentioning

confidence: 78%

Task force report: Scales for screening and evaluating tremor: Critique and recommendations

et al. 2013

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“…So far, sensitivity to change of a clinical scale has only been shown for the daily variation of ET in upper limb tremor 4 and in a case series of five patients after DBS 5 . Our results systematically show that a change of ET after intake of a standardized amount of ethanol is captured equally well by the TETRAS Performance scale, used clinically, as by accelerometry, used as the gold standard measurement for quantifying tremor amplitude 12,15 .…”

Section: Discussionmentioning

confidence: 99%

“…One recent study on temporal fluctuations in ET over six hours has demonstrated a good correlation of a quantitative motor assessment system with TETRAS for upper limb tremor, a subset of the TETRAS Performancescale 4 . Another study showed substantial changes of scores using the same subset after deep brain stimulation (DBS) in five patients 5 . Sensitivity to change after pharmacological intervention, either on the hand subset or of the whole TETRAS Performance scale, has not been reported to date.…”

Section: Introductionmentioning

confidence: 99%

Alcohol challenge and sensitivity to change of the essential tremor rating assessment scale

et al. 2013

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Background The Essential Tremor (ET) Rating Assessment Scale (TETRAS) has shown excellent inter- and intra-rater reliability. To assess the scale’s ability to detect changes in tremor severity, we compared TETRAS performance with standard postural tremor accelerometry during a standardized ethanol challenge. Methods Fifteen adult ET patients received a single oral ethanol dose calculated to reach 0.05 g/dl breath alcohol content (brAC) on two different study days. Two investigators independently assessed the effects with accelerometry on one day and with TETRAS on another day. Measurements were taken at 8 time-points (2 time-points baseline and 6 time-points up to 2 hours post ethanol). Further outcome measures included brAC readings at the same time points. Results Because correlation between TETRAS and accelerometry revealed a logarithmic relation, for all comparisons, accelerometry data were log-transformed and a cumulative score logACC(R+L) was calculated. Correlation between logACC(R+L) and TETRAS was significant (r= 0.57, p<0.01). Repeated measures ANOVA for both TETRAS and accelerometry before and after ethanol showed a significant effect of time-point (F=34.6, p<0.01; F=13.5, p<0.01). Corrected post-hoc tests showed a difference between baseline and each of the following 6 time-points. TETRAS and brAC were significantly correlated (r=−0.29, p<0.01). Intra-rater test-retest analysis between baseline measures showed high correlation (ICC=0.974, p<0.001). The ethanol challenge showed excellent reproducibility. Conclusion We demonstrated sensitivity of the TETRAS performance scale to change after a therapeutic intervention. Our study provides responsiveness validity for TETRAS, further establishing its potential as a valid instrument for ET evaluation in both clinical and research settings.

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“…Surgery was performed according to established DBS procedures described previously [13]. Briefly, we used surgical planning software (Leksell SurgiPlan, version 10.1.1; Elekta AB, Stockholm, Sweden) and a 1.5-T MRI system (Achieva 2.6.3.1; Philips, Best, The Netherlands) to target the Vim nucleus under the guidance of a stereotactic frame (Leksell Coordinate Frame G; Elekta AB).…”

Section: Methodsmentioning

confidence: 99%

Comparative Evaluation of Magnetic Resonance-Guided Focused Ultrasound Surgery for Essential Tremor

Kim

Jung

Park

et al. 2017

Stereotact Funct Neurosurg

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Background: Treatment options for patients with drug-resistant essential tremor (ET) are limited. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is an emerging technique to treat refractory ET. Objectives: To present MRgFUS as an alternative to radiofrequency (RF) thalamotomy or deep brain stimulation (DBS) for ET treatment. Methods: We retrospectively analyzed 59 patients who underwent unilateral surgery for drug-resistant ET. Treatments included RF thalamotomy (n = 17), DBS (n = 19), and MRgFUS (n = 23). The outcomes measured were tremor severity and treatment-related complications. Results: At 1 month postoperatively, 100% of RF thalamotomy patients, 89.5% of DBS patients, and 91.3% of MRgFUS patients exhibited absent/mild tremor (successful treatment); other patients exhibited partial relief. At 12 months postoperatively, treatment success for each procedure was observed in 70.6, 84.2, and 78.3% of patients, respectively. At 1 month postoperatively, treatment-related complications had occurred in 58.8, 5.3, and 13.0% of patients, respectively. At 12 months postoperatively, side effects persisted in 11.8, 21.1, and 4.4% of patients, respectively. No statistical differences in treatment success were observed between treatments or over time. Complication rates differed between treatment modalities (p < 0.01) and were lowest in the MRgFUS group. Conclusions: Patients with drug-resistant ET received equivalent results from RF thalamotomy, DBS, and MRgFUS. DBS and MRgFUS resulted in fewer treatment-related complications.

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Simultaneous Thalamic and Posterior Subthalamic Electrode Insertion With Single Deep Brain Stimulation Electrode for Essential Tremor

Cited by 22 publications

References 34 publications

Task force report: Scales for screening and evaluating tremor: Critique and recommendations

Task force report: Scales for screening and evaluating tremor: Critique and recommendations

Alcohol challenge and sensitivity to change of the essential tremor rating assessment scale

Comparative Evaluation of Magnetic Resonance-Guided Focused Ultrasound Surgery for Essential Tremor

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