Deep brain stimulation of the ventral intermediate nucleus of the thalamus in medically refractory orthostatic tremor: preliminary observations.
Identifieur interne : 002278 ( Ncbi/Curation ); précédent : 002277; suivant : 002279Deep brain stimulation of the ventral intermediate nucleus of the thalamus in medically refractory orthostatic tremor: preliminary observations.
Auteurs : Alberto J. Espay [États-Unis] ; Andrew P. Duker ; Robert Chen ; Michael S. Okun ; Edwin T. Barrett ; Johnna Devoto ; Pamela Zeilman ; Maureen Gartner ; Noël Burton ; Helard A. Miranda ; George T. Mandybur ; Theresa A. Zesiewicz ; Kelly D. Foote ; Fredy J. RevillaSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2008.
English descriptors
- KwdEn :
- MESH :
- methods : Deep Brain Stimulation, Electromyography.
- physiology : Thalamus.
- physiopathology : Tremor.
- surgery : Thalamus.
- therapy : Tremor.
- Aged, Female, Humans, Neuropsychological Tests.
Abstract
Orthostatic tremor (OT) is a disabling movement disorder associated with postural and gait impairment in the elderly. Medical therapy often yields insufficient benefit. We report the clinical and electrophysiological data on two patients with medication-refractory OT treated with deep brain stimulation of the ventral intermediate thalamic nucleus (Vim DBS). Patient 1 underwent bilateral deep brain stimulation (DBS) and Patient 2 unilateral Vim DBS following 28 and 30 years of disease duration, respectively. Both patients showed increased latency to symptom onset after rising from a seated position, improved tolerance for prolonged standing, and slower crescendo of tremor severity when remaining upright. Postoperative evaluation demonstrated decreased amplitude of electromyographic activity with persistence of well-defined oscillatory behavior showing strong coherence at 15 Hz between all muscles tested in the upper and lower limbs. Postural sway was unchanged. Clinical benefits have been sustained for over 18 months in Patient 1, and receded after 3 months in Patient 2. These findings support the consideration of bilateral Vim DBS implantation as a therapeutic option in patients with medically refractory OT. Further efficacy studies on chronic stimulation to disrupt the abnormal oscillatory activity in this disorder are warranted.
DOI: 10.1002/mds.22271
PubMed: 18759339
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Okun</name></author><author><name sortKey="Barrett, Edwin T" sort="Barrett, Edwin T" uniqKey="Barrett E" first="Edwin T" last="Barrett">Edwin T. Barrett</name></author><author><name sortKey="Devoto, Johnna" sort="Devoto, Johnna" uniqKey="Devoto J" first="Johnna" last="Devoto">Johnna Devoto</name></author><author><name sortKey="Zeilman, Pamela" sort="Zeilman, Pamela" uniqKey="Zeilman P" first="Pamela" last="Zeilman">Pamela Zeilman</name></author><author><name sortKey="Gartner, Maureen" sort="Gartner, Maureen" uniqKey="Gartner M" first="Maureen" last="Gartner">Maureen Gartner</name></author><author><name sortKey="Burton, Noel" sort="Burton, Noel" uniqKey="Burton N" first="Noël" last="Burton">Noël Burton</name></author><author><name sortKey="Miranda, Helard A" sort="Miranda, Helard A" uniqKey="Miranda H" first="Helard A" last="Miranda">Helard A. Miranda</name></author><author><name sortKey="Mandybur, George T" sort="Mandybur, George T" uniqKey="Mandybur G" first="George T" last="Mandybur">George T. Mandybur</name></author><author><name sortKey="Zesiewicz, Theresa A" sort="Zesiewicz, Theresa A" uniqKey="Zesiewicz T" first="Theresa A" last="Zesiewicz">Theresa A. Zesiewicz</name></author><author><name sortKey="Foote, Kelly D" sort="Foote, Kelly D" uniqKey="Foote K" first="Kelly D" last="Foote">Kelly D. Foote</name></author><author><name sortKey="Revilla, Fredy J" sort="Revilla, Fredy J" uniqKey="Revilla F" first="Fredy J" last="Revilla">Fredy J. Revilla</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2008" type="published">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Deep Brain Stimulation (methods)</term><term>Electromyography (methods)</term><term>Female</term><term>Humans</term><term>Neuropsychological Tests</term><term>Thalamus (physiology)</term><term>Thalamus (surgery)</term><term>Tremor (physiopathology)</term><term>Tremor (therapy)</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term><term>Electromyography</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Thalamus</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Thalamus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Tremor</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Neuropsychological Tests</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Orthostatic tremor (OT) is a disabling movement disorder associated with postural and gait impairment in the elderly. Medical therapy often yields insufficient benefit. We report the clinical and electrophysiological data on two patients with medication-refractory OT treated with deep brain stimulation of the ventral intermediate thalamic nucleus (Vim DBS). Patient 1 underwent bilateral deep brain stimulation (DBS) and Patient 2 unilateral Vim DBS following 28 and 30 years of disease duration, respectively. Both patients showed increased latency to symptom onset after rising from a seated position, improved tolerance for prolonged standing, and slower crescendo of tremor severity when remaining upright. Postoperative evaluation demonstrated decreased amplitude of electromyographic activity with persistence of well-defined oscillatory behavior showing strong coherence at 15 Hz between all muscles tested in the upper and lower limbs. Postural sway was unchanged. Clinical benefits have been sustained for over 18 months in Patient 1, and receded after 3 months in Patient 2. These findings support the consideration of bilateral Vim DBS implantation as a therapeutic option in patients with medically refractory OT. Further efficacy studies on chronic stimulation to disrupt the abnormal oscillatory activity in this disorder are warranted.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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