Deep Brain Stimulation in the Ventrolateral Thalamus/Subthalamic Area in Dystonia With Head Tremor

作者：Pauls K Amande M^*; Hammesfahr Sven; Moro Elena; Moore A Peter; Binder Ellen; El Majdoub Faycal; Fink Gereon R; Sturm Volker; Krauss Joachim K; Maarouf Mohammad; Timmermann Lars

来源：Movement Disorders, 2014, 29(7): 953-959.

DOI：10.1002/mds.25884

• dystonic tremor
• treatment
• pain
• kinematic tremor analysis

Background: Pallidal deep brain stimulation (GPi-DBS) effectively ameliorates idiopathic dystonia, although approximately 15% of patients respond insufficiently. Although various thalamic and subthalamic targets have been suggested for dystonic tremor, no systematic studies have been published on thalamic DBS in dystonic tremor. We assessed the effect of thalamic/subthalamic area DBS (Th-DBS) on dystonic head tremor and dystonia in a single-blind design. %26lt;br%26gt;Methods: Dystonic head tremor and dystonia before and 3 months after surgery were quantified via blinded video-ratings using the Fahn-Tolosa-Marin-Tremor-Scale and the Burke-Fahn-Marsden-Dystonia-Rating-Scale in seven patients with idiopathic cervical or segmental dystonia, dystonic head tremor, and bilateral Th-DBS. Pain, side effects, adverse events, and stimulation parameters were assessed. %26lt;br%26gt;Results: Th-DBS improved dystonic tremor and dystonia (P %26lt; 0.05; 57.1% and 70.4%, respectively). Head tremor amplitude and pain were also improved (P %26lt; 0.05; 77.5% and 90.0%, respectively). Side effects included dysarthria, gait disturbance, slowness of movement, and weight gain. %26lt;br%26gt;Conclusion: Dystonic head tremor and dystonia can be improved with Th-DBS.

• 出版日期2014-6