Long-term efficacy of thalamic deep brain stimulation for tremor: double-blind assessments.
Identifieur interne : 003855 ( PubMed/Corpus ); précédent : 003854; suivant : 003856Long-term efficacy of thalamic deep brain stimulation for tremor: double-blind assessments.
Auteurs : Stig Rehncrona ; Bo Johnels ; H Kan Widner ; Anna-Lena Törnqvist ; Marwan Hariz ; Olof SydowSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2003.
English descriptors
- KwdEn :
- Aged, Disease Progression, Double-Blind Method, Electric Stimulation Therapy (methods), Essential Tremor (epidemiology), Essential Tremor (etiology), Essential Tremor (therapy), Female, Follow-Up Studies, Humans, Male, Observer Variation, Parkinson Disease (complications), Thalamus (physiology), Time.
- MESH :
- complications : Parkinson Disease.
- epidemiology : Essential Tremor.
- etiology : Essential Tremor.
- methods : Electric Stimulation Therapy.
- physiology : Thalamus.
- therapy : Essential Tremor.
- Aged, Disease Progression, Double-Blind Method, Female, Follow-Up Studies, Humans, Male, Observer Variation, Time.
Abstract
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.
DOI: 10.1002/mds.10309
PubMed: 12539209
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pubmed:12539209Le document en format XML
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<author><name sortKey="Rehncrona, Stig" sort="Rehncrona, Stig" uniqKey="Rehncrona S" first="Stig" last="Rehncrona">Stig Rehncrona</name>
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<author><name sortKey="Johnels, Bo" sort="Johnels, Bo" uniqKey="Johnels B" first="Bo" last="Johnels">Bo Johnels</name>
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<author><name sortKey="Widner, H Kan" sort="Widner, H Kan" uniqKey="Widner H" first="H Kan" last="Widner">H Kan Widner</name>
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<author><name sortKey="Tornqvist, Anna Lena" sort="Tornqvist, Anna Lena" uniqKey="Tornqvist A" first="Anna-Lena" last="Törnqvist">Anna-Lena Törnqvist</name>
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<author><name sortKey="Hariz, Marwan" sort="Hariz, Marwan" uniqKey="Hariz M" first="Marwan" last="Hariz">Marwan Hariz</name>
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<author><name sortKey="Sydow, Olof" sort="Sydow, Olof" uniqKey="Sydow O" first="Olof" last="Sydow">Olof Sydow</name>
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<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Observer Variation</term>
<term>Parkinson Disease (complications)</term>
<term>Thalamus (physiology)</term>
<term>Time</term>
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<term>Disease Progression</term>
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<front><div type="abstract" xml:lang="en">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.</div>
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<Abstract><AbstractText>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.</AbstractText>
<CopyrightInformation>Copyright 2002 Movement Disorder Society</CopyrightInformation>
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