Surgical therapy for tremor in multiple sclerosis

Matsumoto, Joseph Y.; Morrow, Duane A.; Kaufman, K.R.; Davis, D. H.; Ahlskog, J. Eric; Walker, Anna; Sneve, D.; Noseworthy, John H.; Rodriguez, Moses

doi:10.1212/wnl.57.10.1876

Cited by 53 publications

(50 citation statements)

References 24 publications

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“…Matsumoto and colleagues provide a review of considerations and options for measuring tremor suppression and the practical effects of DBS surgery in multiple sclerosis. 16 They present a clinical tremor rating scale, a novel quantitative movement analysis technique, and a box-and-blocks test of prehensile function Postoperative magnetic resonance imaging revealed no evidence of intraoperative haemorrhage. One additional patient had an intraoperative seizure so implantation was not completed at that time.…”

Section: Discussionmentioning

confidence: 99%

“…Multidimensional assessment appropriate to the expected range of surgical benefit is most likely to be an accurate reflection of the effects of surgery. 16 Therefore, prospective longitudinal studies using multidimensional outcome measurements are needed.…”

Section: Discussionmentioning

confidence: 99%

“…In the studies from which relevant information could be gleaned, 76% of patients with multiple sclerosis showed benefit in terms of ability to grasp objects, self feed, print, write, or perform other everyday functions. 7 8 11 18 These studies, however, accounted for only 25 of the 75 patients reported so far, and some studies showed no significant benefit in terms of everyday functioning (for example, Matsumoto 16 ). Thus the practical impact of chronic DBS on everyday activities requires further examination, giving careful attention to selection of outcome measures appropriate to the range of potential benefit in the sample being studied.…”

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confidence: 99%

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Chronic deep brain stimulation for the treatment of tremor in multiple sclerosis: review and case reports

Wishart

2003

Journal of Neurology, Neurosurgery & Psychiatry

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Background: Deep brain stimulation (DBS) offers a non-ablative alternative to thalamotomy for the surgical treatment of medically refractory tremor in multiple sclerosis. However, relatively few outcomes have been reported. Objective: To provide a systematic review of the published cases of DBS use in multiple sclerosis and to present four additional patients. Methods: Quantitative and qualitative review of the published reports and description of a case series from one centre. Results: In the majority of reported cases (n = 75), the surgical target for DBS implantation was the ventrointeromedial nucleus of the thalamus. Tremor reduction and improvement in daily functioning were achieved in most patients, with 87.7% experiencing at least some sustained improvement in tremor control postsurgery. Effects on daily functioning were less consistently assessed across studies; in papers reporting relevant data, 76.0% of patients experienced improvement in daily functioning. Adverse effects were similar to those reported for DBS in other patient populations. Conclusions: Few of the studies reviewed used highly standardised quantitative outcome measures, and follow up periods were generally one year or less. Nonetheless, the data suggest that chronic DBS often produces improved tremor control in multiple sclerosis. Complete cessation of tremor is not necessarily achieved, there are cases in which tremor control decreases over time, and frequent reprogramming appears to be necessary.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Chronic deep brain stimulation for the treatment of tremor in multiple sclerosis: review and case reports

Wishart

2003

Journal of Neurology, Neurosurgery & Psychiatry

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“…41 Clinical improvement in these patients is often short lived and, in the case of multiple sclerosis, complicated by disease progression. 42,43 Although treatment for tremor targets the ventral intermediate nucleus, several studies have suggested that the posterior subthalamic area is a better location and that patients may be incidentally benefiting from electrode contacts located outside of the thalamus. 44 Overall, DBS for essential and parkinsonian tremor has been successful, while treatment of other causes of tremor has been more limited.…”

Section: Tremormentioning

confidence: 99%

History, Applications, and Mechanisms of Deep Brain Stimulation

et al. 2013

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“…The authors reported, "Tremors, both proximal and distal, were remarkably improved in all eight patients…" when using monopolar stimulation. Scoring used a modified clinical tremor rating scale [71]. A mean 81% tremor improvement was observed when using the best contact on each electrode.…”

Section: Posterior Subthalamic Area Stimulation With Emphasis On the mentioning

confidence: 99%

Emerging Targets for Stimulation-Refractory Movement Disorders

Boulis¹

2011

TONEUROSJ

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Deep brain stimulation has proven an effective addition to the optimized medical management of some primary movement disorders. Sustained symptomatic improvement has been demonstrated for Parkinson's disease, forms of dystonia, and essential tremor. However, despite dramatic improvements in the tremor, rigidity, bradykinesia, and dyskinesias of Parkinson's disease, DBS of the STN and GPi have provided inconsistent relief of gate abnormalities and freezing. Similarly, DBS of the Vim has proven effective for distal tremors resulting from a variety of etiologies, but has limited efficacy for tremors with proximal spread. Accumulating clinical, neurophysiologic, and neuroanatomic evidence supports the pedunculopontine nucleus as a modulator of postural control and gait initiation. Further, both historical and contemporary preclinical and clinical data support the zona incerta and prelemniscal radiations as targets within the greater subthalamic area for tremor containing proximal spread. On the basis of these observations, there is considerable interest in PPN DBS for control of gate abnormalities in PD, and in ZI and PRL DBS as a means for modulation of pronounced tremor with axial involvement. The clinical evidence for consideration of the PPN and ZI/PRL as alternate stimulation targets for treatment of refractory movement disorder manifestations is reviewed.

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Surgical therapy for tremor in multiple sclerosis

Cited by 53 publications

References 24 publications

Chronic deep brain stimulation for the treatment of tremor in multiple sclerosis: review and case reports

Chronic deep brain stimulation for the treatment of tremor in multiple sclerosis: review and case reports

History, Applications, and Mechanisms of Deep Brain Stimulation

Emerging Targets for Stimulation-Refractory Movement Disorders

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