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Bilateral Posterior Subthalamic Area Deep Brain Stimulation for Essential Tremor: A Case Series

BACKGROUND: Deep brain stimulation (DBS) of the posterior subthalamic area (PSA) provides a potentially effective treatment for medication-refractory essential tremor (ET). OBJECTIVE: To study the clinical benefits and adverse-event profile of bilateral PSA-DBS for refractory ET. METHODS: Seven pati...

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Detalles Bibliográficos
Autores principales: Sun, Xiaoyu, Huang, Luke, Pan, Yixin, Zhang, Chencheng, Wang, Tao, Li, Hongxia, Sun, Bomin, Ding, Jianqing, Wu, Yiwen, Li, Dianyou
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013085/
https://www.ncbi.nlm.nih.gov/pubmed/32116604
http://dx.doi.org/10.3389/fnhum.2020.00016
Descripción
Sumario:BACKGROUND: Deep brain stimulation (DBS) of the posterior subthalamic area (PSA) provides a potentially effective treatment for medication-refractory essential tremor (ET). OBJECTIVE: To study the clinical benefits and adverse-event profile of bilateral PSA-DBS for refractory ET. METHODS: Seven patients with refractory ET underwent bilateral PSA-DBS surgery under general anesthesia between September 2017 and May 2018. Clinical outcome assessments, using the Essential Tremor Rating Scale, were performed at 1-, 6-, and 12-month follow-up, except for the last assessment of one patient who was followed up to 9 months. Analysis was focused on changes in patients’ motor symptoms and quality of life following surgery as well as documenting the adverse-event profile associated with the surgical PSA-DBS treatment. RESULTS: After surgery, patients’ motor symptoms, including upper limb tremor and head tremor, were improved by 84.2% and their quality of life by 81.25% at 1-month follow-up. The clinical benefits to patients were maintained at 6-month and last follow-up. Adverse side effects included dysarthria (n = 4), balance disorder (n = 2), and paresthesia of the right limb (n = 1). No habituation effects were observed throughout the follow-up. CONCLUSION: Bilateral PSA-DBS seems to offer an effective and safe alternative treatment for medically intractable ET, warranting further research into its clinical utility, adverse-event profile, and comparative effectiveness.