Naslov
Thalamic deep brain stimulation in patients with atypical tremor syndromes

Autori
Mielke, Carina ; Waechter Tobias ; Lisčić, Rajka ; Weiss, Daniel ; Breit, Sorin ; Gharabaghi, A. ; Plewnia, C. ; Krueger, Rejko

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstracts of The 8th German Parkinson Congress ; u: Basal Ganglia 3 (2013) (1) / Jost, Wolfgang, H. - Wiesbaden : Elsevier, 2013, 69-69

Skup
German Parkinson Congress (8 ; 2013)

Mjesto i datum
Würzburg, Njemačka, 13.03.2013. - 15.03.2013

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
deep brain stimulation; thalamus; Holmes tremor; FXTAS

Sažetak
Deep brain stimulation is a well-established interventional treatment for essential tremor or tremor-dominant Parkinson’s disease. However, less is known about the effect of deep brain stimulation in patients with atypical tremor syndromes. Methods To investigate whether deep brain stimulation in the thalamus is an effective treatment option for patients with atypical tremor syndromes, we examined patients with genetically proven fragile X tremor ataxia syndrome (FXTAS) and patients with Holmes tremor preoperative, in a short term and long term follow-up. Patients with fragile X tremor ataxia syndrome (n=3) treated with deep brain stimulation of the VIM and patients with Holmes tremor (n=2) treated with combined VIM plus VOA stimulation after failure of pharmaceutical therapeutic approaches. A detailed clinical examination was performed preoperatively and patients were followed postoperatively for short term (2 months) and long term (12 and 24 months) examinations including Tremor Rating Scale, International Co-operative Ataxia Rating Scale, Mini-Mental Status Examination, Becks Depression Inventory. Results Two out of three patients with FXTAS revealed a sustained improvement in both scales (Tremor Rating Scale and International Co-operative Ataxia Rating Scale) in the short-term and in the long-term follow-up. However, symptoms (tremor, ataxia) worsened gradually over time due to progression of the disease. For two patients treated with Holmes tremor the clinical scales demonstrated minor alterations at 2 month, 1 year and the 2 year follow-up, with only moderate improvement in one patient. Interestingly, one patient reported a subjectively relevant improvement of tremor with regained hand function that is not captured by the rating scales. Conclusions We present a prospective series of patients treated with DBS in the thalamus due to tremor syndromes based on a genetic defect (FXTAS) or traumatic lesion (Holmes tremor) that were followed up to 2 years. Interestingly clinical relevant improvement of tremor in FXTAS was observed without stimulation-induced worsening of ataxia, as a potential side effect of VIM-DBS. Our observations argue in favour of heterogeneous outcomes in patients with both atypical tremor syndromes, with a sustained improvement in tremor and ataxia rating scales in some of the patients, whereas others show no response of the tremor to thalamic stimulation.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

Napomena
DOI: 10.1016/j.baga.2013.01.079

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