Stereotactic neurosurgery for disabling tremor in multiple sclerosis: thalamotomy or deep brain stimulation?

Yap, L.; Kouyialis, Andreas T.; Varma, T. R. K.

doi:10.1080/02688690701544002

Cited by 58 publications

(29 citation statements)

References 31 publications

(34 reference statements)

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“…The majority of reports of stereotactic surgery in MS tremor have targeted thalamic structures with variable results (64, 65). In the Cochrane review, one neurosurgical study of thalamotomy versus thalamic stimulation was included (53).…”

Section: Treatments For Cerebellar Disease In Msmentioning

confidence: 99%

Cerebellar Dysfunction in Multiple Sclerosis

Wilkins

2017

Front. Neurol.

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Multiple sclerosis (MS) commonly affects the cerebellum causing acute and chronic symptoms. Cerebellar signs contribute significantly to clinical disability, and symptoms such as tremor, ataxia, and dysarthria are particularly difficult to treat. Increasing knowledge concerning the pathophysiology of cerebellar disease in MS from human postmortem studies, experimental models, and clinical trials has raised the hope that cerebellar symptoms will be better treated in the future.

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Section: Treatments For Cerebellar Disease In Msmentioning

confidence: 99%

Cerebellar Dysfunction in Multiple Sclerosis

Wilkins

2017

Front. Neurol.

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“…It makes performing daily life activities very challenging, and may contribute to feelings of social isolation and depression. Invasive treatments are often considered too risky due to adverse effects after surgery and during long-term follow-up observations [11,26,28,33]. Pharmacological methods have also not proved successful in treating intention tremor [5], hence there is increasing research interest in non-pharmacological treatment approaches.…”

Section: Introductionmentioning

confidence: 99%

System identification for FES-based tremor suppression

Copur

Freeman

Chu

et al. 2016

European Journal of Control

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Tremor is an involuntary motion which is a common complication of Parkinson's disease and Multiple Sclerosis. A promising treatment is to artificially contract the muscle through application of induced electrical stimulation. However, existing controllers have either provided only modest levels of suppression or have been applied only in simulation. To enable more advanced, model-based control schemes, an accurate model of the relevant limb dynamics is required, together with identification procedures that are suitable for clinical application. This paper proposes such a solution, explicitly addressing limitations of existing methodologies. These include model structures that: (i) neglect critical features, and (ii) restrict the range of admissible control schemes, together with identification procedures that: (iii) employ stimulation inputs that are uncomfortable for patients, (iv) are overly complex and time-consuming for clinical use, and (v) cannot be automated. Experimental results confirm the efficacy of the proposed identification procedures, and show that high levels of accuracy can be achieved in a short identification time using test procedures that are suitable for future transference to the clinical domain.

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“…These studies do show safety, efficacy, and functional improvement [44,Class III]. When determining surgical candidacy it is important to differentiate tremor from ataxia, since only tremor will be alleviated by surgery.…”

Section: Stereotactic Neurosurgerymentioning

confidence: 98%

Therapeutic Interventions in the Primary Hereditary Ataxias

Revuelta

Wilmot

2010

Curr Treat Options Neurol

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The treatment of hereditary ataxia is primarily supportive. With very few exceptions (eg, ataxia associated with vitamin E deficiency), there are no disease-modifying therapies. Despite the lack of disease-modifying treatments, there can be great value in obtaining an accurate diagnosis of hereditary ataxia subtype. Benefits include determining prognosis, facilitating family counseling, improving research access, and providing some psychological benefit in ending the often frustrating search for an accurate etiology. Hereditary ataxias may have certain clinical features that respond very well to symptomatic medical therapy. Parkinsonism, dystonia, spasticity, urinary urgency, sleep pathology, fatigue, and depression are all common in many of the ataxia subtypes and very often respond to pharmacologic intervention as in other diseases. Much of the clinical interaction between neurologist and ataxia patient should focus on identifying and treating these symptoms. Treatment of the core clinical feature of these diseases-ataxia-is predominantly rehabilitative. The value of good physical therapy far exceeds any potential benefit from medications that a physician might prescribe to improve balance and coordination. Speech and swallowing are often affected. In more severe cases, aspiration risk can be very significant and life-threatening. Routine monitoring of swallowing by speech therapists, often including modified barium swallowing tests, is indicated in most patients. Recently there have been very encouraging advances in clinical ataxia research. Collaborative study groups throughout the world have developed and validated ataxia rating scales and instrumented outcome measures and have begun to rigorously define the natural history of these diseases, thus laying the foundation for well-designed clinical trials. The promise of disease-modifying treatments is closer than ever.

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Stereotactic neurosurgery for disabling tremor in multiple sclerosis: thalamotomy or deep brain stimulation?

Cited by 58 publications

References 31 publications

Cerebellar Dysfunction in Multiple Sclerosis

Cerebellar Dysfunction in Multiple Sclerosis

System identification for FES-based tremor suppression

Therapeutic Interventions in the Primary Hereditary Ataxias

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