Predictors of deep brain stimulation outcome in tremor patients
Background: Deep brain stimulation of the ventro-intermedius nucleus of the thalamus is an established treatment for tremor of differing etiologies but factors that may predict the short- and especially long-term outcome of surgery are still largely unknown. Methods: We retrospectively investigated...
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Format: | Article |
Language: | English |
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Elsevier
2018-05-01
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Series: | Brain Stimulation |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S1935861X17310306 |
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doaj-985fa90683084b80b36ea12c3e00bd49 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Claire Sandoe Vibhor Krishna Diellor Basha Francesco Sammartino Joao Tatsch Marina Picillo Lazzaro di Biase Yu-Yan Poon Clement Hamani Duemani Reddy Renato P. Munhoz Andres M. Lozano William D. Hutchison Alfonso Fasano |
spellingShingle |
Claire Sandoe Vibhor Krishna Diellor Basha Francesco Sammartino Joao Tatsch Marina Picillo Lazzaro di Biase Yu-Yan Poon Clement Hamani Duemani Reddy Renato P. Munhoz Andres M. Lozano William D. Hutchison Alfonso Fasano Predictors of deep brain stimulation outcome in tremor patients Brain Stimulation Deep brain stimulation Outcome Predictors Tremor |
author_facet |
Claire Sandoe Vibhor Krishna Diellor Basha Francesco Sammartino Joao Tatsch Marina Picillo Lazzaro di Biase Yu-Yan Poon Clement Hamani Duemani Reddy Renato P. Munhoz Andres M. Lozano William D. Hutchison Alfonso Fasano |
author_sort |
Claire Sandoe |
title |
Predictors of deep brain stimulation outcome in tremor patients |
title_short |
Predictors of deep brain stimulation outcome in tremor patients |
title_full |
Predictors of deep brain stimulation outcome in tremor patients |
title_fullStr |
Predictors of deep brain stimulation outcome in tremor patients |
title_full_unstemmed |
Predictors of deep brain stimulation outcome in tremor patients |
title_sort |
predictors of deep brain stimulation outcome in tremor patients |
publisher |
Elsevier |
series |
Brain Stimulation |
issn |
1935-861X |
publishDate |
2018-05-01 |
description |
Background: Deep brain stimulation of the ventro-intermedius nucleus of the thalamus is an established treatment for tremor of differing etiologies but factors that may predict the short- and especially long-term outcome of surgery are still largely unknown. Methods: We retrospectively investigated the clinical, pharmacological, electrophysiological and anatomical features that might predict the initial response and preservation of benefit in all patients who underwent deep brain stimulation for tremor. Data were collected at the following time points: baseline (preoperative), one-year post-surgery, and most recent visit. Tremor severity was recorded using the Fahn-Tolosa-Marin Tremor Rating Scale and/or the Unified Parkinson's Disease Rating Scale. Results: A total of 52 patients were included in the final analysis: 31 with essential tremor, 15 with cerebellar tremor of different etiologies, and 6 with Parkinson's disease. Long-term success (mean follow-up duration 34.7 months, range 1.7–121.1 months) was reported in 63.5%. Predictors of long-term benefit were: underlying tremor etiology (best outcome in Parkinson's disease, worst outcome in cerebellar tremor); age at surgery (the older the better); baseline tremor severity (the greater the better); lack of response to benzodiazepines; a more anterior electrode placement and single-unit beta power (the greater the better). Conclusions: Specific patients' features (including single unit beta activity) and electrode locations may predict the short- and long-term benefit of thalamic stimulation for tremor. Future prospective studies enrolling a much larger sample of patients are needed to substantiate the associations detected by this retrospective study. |
topic |
Deep brain stimulation Outcome Predictors Tremor |
url |
http://www.sciencedirect.com/science/article/pii/S1935861X17310306 |
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doaj-985fa90683084b80b36ea12c3e00bd492021-03-19T07:11:33ZengElsevierBrain Stimulation1935-861X2018-05-01113592599Predictors of deep brain stimulation outcome in tremor patientsClaire Sandoe0Vibhor Krishna1Diellor Basha2Francesco Sammartino3Joao Tatsch4Marina Picillo5Lazzaro di Biase6Yu-Yan Poon7Clement Hamani8Duemani Reddy9Renato P. Munhoz10Andres M. Lozano11William D. Hutchison12Alfonso Fasano13Edmond J. Safra Program in Parkinson's Disease and Morton, Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital and Division of Neurology, University of Toronto, Toronto, Ontario, CanadaCenter for Neuromodulation, Department of Neurosurgery, The Ohio State University, Columbus, OH, USAKrembil Research Institute, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, CanadaCenter for Neuromodulation, Department of Neurosurgery, The Ohio State University, Columbus, OH, USAKrembil Research Institute, Toronto, Ontario, Canada; Division of Neurosurgery, University of Toronto, Toronto, Ontario, CanadaCenter for Neurodegenerative Diseases (CEMAND), Department of Medicina and Surgery, University of Salerno, ItalyNeurology Unit, Campus Bio-Medico University of Rome, Rome, ItalyEdmond J. Safra Program in Parkinson's Disease and Morton, Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital and Division of Neurology, University of Toronto, Toronto, Ontario, CanadaKrembil Research Institute, Toronto, Ontario, Canada; Division of Neurosurgery, University of Toronto, Toronto, Ontario, CanadaDivision of Neurosurgery, University of Toronto, Toronto, Ontario, CanadaEdmond J. Safra Program in Parkinson's Disease and Morton, Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital and Division of Neurology, University of Toronto, Toronto, Ontario, CanadaKrembil Research Institute, Toronto, Ontario, Canada; Division of Neurosurgery, University of Toronto, Toronto, Ontario, CanadaKrembil Research Institute, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, CanadaEdmond J. Safra Program in Parkinson's Disease and Morton, Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital and Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Krembil Research Institute, Toronto, Ontario, Canada; Corresponding author. Division of Neurology - University of Toronto, Movement Disorders Centre - Toronto Western Hospital, 399 Bathurst St, 7 Mc412, Toronto, M5T 2S8, Ontario, Canada.Background: Deep brain stimulation of the ventro-intermedius nucleus of the thalamus is an established treatment for tremor of differing etiologies but factors that may predict the short- and especially long-term outcome of surgery are still largely unknown. Methods: We retrospectively investigated the clinical, pharmacological, electrophysiological and anatomical features that might predict the initial response and preservation of benefit in all patients who underwent deep brain stimulation for tremor. Data were collected at the following time points: baseline (preoperative), one-year post-surgery, and most recent visit. Tremor severity was recorded using the Fahn-Tolosa-Marin Tremor Rating Scale and/or the Unified Parkinson's Disease Rating Scale. Results: A total of 52 patients were included in the final analysis: 31 with essential tremor, 15 with cerebellar tremor of different etiologies, and 6 with Parkinson's disease. Long-term success (mean follow-up duration 34.7 months, range 1.7–121.1 months) was reported in 63.5%. Predictors of long-term benefit were: underlying tremor etiology (best outcome in Parkinson's disease, worst outcome in cerebellar tremor); age at surgery (the older the better); baseline tremor severity (the greater the better); lack of response to benzodiazepines; a more anterior electrode placement and single-unit beta power (the greater the better). Conclusions: Specific patients' features (including single unit beta activity) and electrode locations may predict the short- and long-term benefit of thalamic stimulation for tremor. Future prospective studies enrolling a much larger sample of patients are needed to substantiate the associations detected by this retrospective study.http://www.sciencedirect.com/science/article/pii/S1935861X17310306Deep brain stimulationOutcomePredictorsTremor |