Document Detail


Long-term efficacy of thalamic deep brain stimulation for tremor: double-blind assessments.
MedLine Citation:
PMID:  12539209     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thalamic deep brain stimulation (DBS) is proven to suppress tremor in Parkinson's disease (PD) and essential tremor (ET). However, there are few reports on its long-term efficacy. We studied the efficacy of DBS at 2 years and 6-7 years after electrode implantations in the ventrointermediate nucleus of the thalamus in 39 patients (20 PD, 19 ET) with severe tremor. Twenty-five of the patients completed the study. Evaluations were done in a double-blind manner with the Unified Parkinson's Disease Rating Scale (UPDRS) and Essential Tremor Rating Scale (ETRS). DBS decreased tremor sum scores in PD (P < 0.025) compared to the preoperative baseline (median, 7; Q25-75, 6-9) both at 2 years (median, 2; Q25-75, 2-3.5; n = 16) and at 6 to 7 years (median, 2.5; Q25-75, 0.5-3; n = 12). Stimulation on improved tremor sum as well as sub scores (P < 0.025) compared to stimulation off conditions. In ET, thalamic stimulation improved (P < 0.025) kinetic and positional tremor at both follow-up periods (n = 18 and n = 13, respectively) with significant improvements (P < 0.025) in hand-function tests. PD but not ET patients showed a general disease progression. Stimulation parameters were remarkably stable over time. We conclude that high-frequency electric thalamic stimulation can efficiently suppress severe tremor in PD and ET more than 6 years after permanent implantation of brain electrodes.
Authors:
Stig Rehncrona; Bo Johnels; Håkan Widner; Anna-Lena Törnqvist; Marwan Hariz; Olof Sydow
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Movement disorders : official journal of the Movement Disorder Society     Volume:  18     ISSN:  0885-3185     ISO Abbreviation:  Mov. Disord.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-01-22     Completed Date:  2003-06-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8610688     Medline TA:  Mov Disord     Country:  United States    
Other Details:
Languages:  eng     Pagination:  163-70     Citation Subset:  IM    
Copyright Information:
Copyright 2002 Movement Disorder Society
Affiliation:
The Department of Clinical Neuroscience, Division of Neurosurgery, University in Lund, Sweden. stig.rehncrona@neurokir.lu.se
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MeSH Terms
Descriptor/Qualifier:
Aged
Disease Progression
Double-Blind Method
Electric Stimulation Therapy / methods*
Essential Tremor / epidemiology,  etiology,  therapy*
Female
Follow-Up Studies
Humans
Male
Observer Variation
Parkinson Disease / complications
Thalamus / physiology*
Time

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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