Document Detail

The impact of thalamic stimulation on activities of daily living for essential tremor.
MedLine Citation:
PMID:  12826348     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Deep Brain Stimulation (DBS) of the ventro-intermedius nucleus of the thalamus is the treatment of choice for drug-refractory essential tremor (ET). This study evaluated the effectiveness of thalamic stimulation in improving the patient's quality of life through activities of daily living. METHODS: Sixteen ET patients completed a health questionnaire, the "Tremor Activities of Daily Living Scale" (TADLS) measured by the patient, a 10-item subset of the TADLS measured by the clinician, and the Fahn-Tolosa-Marin tremor rating scale (TRS). Each patient was evaluated with the stimulator on and off with the average evaluation occurring 13 months after surgery. Additionally, improvements on the TADLS were compared to electrode positioning on the axial plane and stimulation parameters. RESULTS: There was a 44.0% improvement in the patient-rated TADLS, a 45.2% improvement in the clinician-rated TADLS, and a 33.9% improvement in the TRS. The average electrode location was 5.65 mm anterior to the posterior commissure (AC-PC), 13.4 mm lateral from the midline, and 2.0 mm below the AC-PC line. The average stimulation parameters were 2.74 Volts, 160 Hertz, and 119 microsec. There was no correlation between improvements on the TADLS, electrode location, and stimulation parameters. Of the 16 patients, 10 patients would repeat the surgery, two were unsure, and four would not repeat the surgery. CONCLUSIONS: Tremor is significantly controlled with DBS and activities of daily living are highly correlated with patient satisfaction. The degree of improvement in the four patients who would not repeat the surgery was outweighed by the negative factors associated with the surgery.
Joshua A Bryant; Antonio De Salles; Cynthia Cabatan; Robert Frysinger; Eric Behnke; Jeff Bronstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  59     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-26     Completed Date:  2003-07-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  479-84; discussion 484-5     Citation Subset:  IM    
UCLA School of Medicine, UCLA, Los Angeles, California, USA.
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MeSH Terms
Activities of Daily Living*
Diplopia / etiology
Dysarthria / etiology,  prevention & control
Electric Stimulation Therapy / adverse effects,  instrumentation*
Electrodes, Implanted
Essential Tremor / therapy*
Paresthesia / etiology
Patient Satisfaction
Thalamus / physiology*

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

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