Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2013:9:1859-65.
doi: 10.2147/NDT.S32342. Epub 2013 Dec 2.

Current clinical application of deep-brain stimulation for essential tremor

Amit Chopra  1 , Bryan T Klassen, Matt Stead
Affiliations
Review

Current clinical application of deep-brain stimulation for essential tremor

Amit Chopra et al. Neuropsychiatr Dis Treat. 2013.

Abstract

Background: Deep-brain stimulation (DBS) is an established treatment for medically refractory essential tremor (ET). This article reviews the current evidence supporting the efficacy and safety of DBS targets, including the ventral intermediate (VIM) nucleus and posterior subthalamic area (PSA) in treatment of ET.

Methods: A structured PubMed search was performed through December 2012 with keywords "deep brain stimulation (DBS)," "essential tremor (ET)," "ventral intermediate (VIM) nucleus," "posterior subthalamic area (PSA)," "safety," and "efficacy."

Results: Based on level IV evidence, both VIM and PSA DBS targets appear to be safe and efficacious in ET patients in tremor reduction and improving activities of daily living, though the literature on PSA DBS is limited in terms of bilateral stimulation and long-term follow-up. DBS-related adverse effects are typically mild and stimulation-related. Hardware-related complications after DBS may not be uncommon, and often require additional surgical procedures. Few studies assessed quality-of-life and cognition outcomes in ET patients undergoing DBS stimulation.

Conclusion: DBS appears to be a safe and effective treatment for medically refractory ET. More systematic studies comparing VIM and PSA targets are needed to ascertain the most safe and effective DBS treatment for medically refractory ET. More research is warranted to assess quality-of-life and cognition outcomes in ET patients undergoing DBS.

Keywords: deep-brain stimulation (DBS); efficacy; essential tremor (ET); posterior subthalamic area (PSA); safety; ventral intermediate (VIM) nucleus.

PubMed Disclaimer

References

    1. Zappia M, Albanese A, Bruno E, et al. Treatment of essential tremor: a systematic review of evidence and recommendations from the Italian Movement Disorders Association. J Neurol. 2013;260(3):714–740. - PubMed
    1. Louis ED, Ottman R, Hauser WA. How common is the most common adult movement disorder? Estimates of the prevalence of essential tremor throughout the world. Mov Disord. 1998;13(1):5–10. - PubMed
    1. Louis ED. Clinical practice. Essential tremor. N Engl J Med. 2001;345(12):887–891. - PubMed
    1. Koller W, Biary N, Cone S. Disability in essential tremor: effect of treatment. Neurology. 1986;36(7):1001–1004. - PubMed
    1. Busenbark KL, Nash J, Nash S, Hubble JP, Koller WC. Is essential tremor benign? Neurology. 1991;41(12):1982–1983. - PubMed