Long-term deep brain stimulation for essential tremor: 12-year clinicopathologic follow-up.
Identifieur interne : 001799 ( PubMed/Checkpoint ); précédent : 001798; suivant : 001800Long-term deep brain stimulation for essential tremor: 12-year clinicopathologic follow-up.
Auteurs : Daniel J. Dilorenzo [États-Unis] ; Joseph Jankovic [États-Unis] ; Richard K. Simpson ; Hidehiro Takei ; Suzanne Z. PowellSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2010.
English descriptors
- KwdEn :
- Aged, Autopsy, Deep Brain Stimulation (adverse effects), Electrodes, Implanted (adverse effects), Essential Tremor (pathology), Essential Tremor (physiopathology), Essential Tremor (therapy), Female, Follow-Up Studies, Gliosis (pathology), Humans, Neurons (pathology), Time Factors, Treatment Outcome, Ventral Thalamic Nuclei (pathology), Ventral Thalamic Nuclei (physiopathology).
- MESH :
- adverse effects : Deep Brain Stimulation, Electrodes, Implanted.
- pathology : Essential Tremor, Gliosis, Neurons, Ventral Thalamic Nuclei.
- physiopathology : Essential Tremor, Ventral Thalamic Nuclei.
- therapy : Essential Tremor.
- Aged, Autopsy, Female, Follow-Up Studies, Humans, Time Factors, Treatment Outcome.
Abstract
We describe the clinical course and postmortem pathological findings in a patient with essential tremor (ET) treated with deep brain stimulation (DBS) for 12 years. This 75 year old woman had a 13-year history of progressive ET prior to implantation of bilateral quadripolar DBS electrodes in the region of her ventral intermediate thalamic nuclei in 1996, producing immediate relief of arm tremor. Histopathological examination of the brain, performed 12 years after the initial implantation, demonstrated electrode catheter tracts rimmed by 20-25 micron fibrous sheaths, with multinucleated giant cells and reactive gliosis. Lymphocytic infiltration was seen by L26 immunoreactivity with CD3 (T cells) staining predominating over CD20 (B cells). Cerebellar axonal spheroids and Purkinje cell loss were found. The minimal foreign body reaction and gliosis around the electrodes 12 years after implantation supports the long-term safety of DBS. The case represents the longest reported follow-up with autopsy examination after DBS and confirmed histological changes associated with ET.
DOI: 10.1002/mds.22935
PubMed: 20063387
Affiliations:
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<term>Essential Tremor (pathology)</term>
<term>Essential Tremor (physiopathology)</term>
<term>Essential Tremor (therapy)</term>
<term>Female</term>
<term>Follow-Up Studies</term>
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<term>Humans</term>
<term>Neurons (pathology)</term>
<term>Time Factors</term>
<term>Treatment Outcome</term>
<term>Ventral Thalamic Nuclei (pathology)</term>
<term>Ventral Thalamic Nuclei (physiopathology)</term>
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<front><div type="abstract" xml:lang="en">We describe the clinical course and postmortem pathological findings in a patient with essential tremor (ET) treated with deep brain stimulation (DBS) for 12 years. This 75 year old woman had a 13-year history of progressive ET prior to implantation of bilateral quadripolar DBS electrodes in the region of her ventral intermediate thalamic nuclei in 1996, producing immediate relief of arm tremor. Histopathological examination of the brain, performed 12 years after the initial implantation, demonstrated electrode catheter tracts rimmed by 20-25 micron fibrous sheaths, with multinucleated giant cells and reactive gliosis. Lymphocytic infiltration was seen by L26 immunoreactivity with CD3 (T cells) staining predominating over CD20 (B cells). Cerebellar axonal spheroids and Purkinje cell loss were found. The minimal foreign body reaction and gliosis around the electrodes 12 years after implantation supports the long-term safety of DBS. The case represents the longest reported follow-up with autopsy examination after DBS and confirmed histological changes associated with ET.</div>
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<Abstract><AbstractText>We describe the clinical course and postmortem pathological findings in a patient with essential tremor (ET) treated with deep brain stimulation (DBS) for 12 years. This 75 year old woman had a 13-year history of progressive ET prior to implantation of bilateral quadripolar DBS electrodes in the region of her ventral intermediate thalamic nuclei in 1996, producing immediate relief of arm tremor. Histopathological examination of the brain, performed 12 years after the initial implantation, demonstrated electrode catheter tracts rimmed by 20-25 micron fibrous sheaths, with multinucleated giant cells and reactive gliosis. Lymphocytic infiltration was seen by L26 immunoreactivity with CD3 (T cells) staining predominating over CD20 (B cells). Cerebellar axonal spheroids and Purkinje cell loss were found. The minimal foreign body reaction and gliosis around the electrodes 12 years after implantation supports the long-term safety of DBS. The case represents the longest reported follow-up with autopsy examination after DBS and confirmed histological changes associated with ET.</AbstractText>
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