Thalamic Deep Brain Stimulation in Essential Tremor Plus Is as Effective as in Essential Tremor
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Protocol Approval, Registration, and Consent
2.3. Data Acquisition and Tremor Analysis
2.4. Active Contact Location and Stimulation Parameters
2.5. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. DBS Effect and Tremor-Scores
3.2.1. TRS in Stimulation-OFF and -ON
3.2.2. TRS at Baseline and Follow-Up
3.2.3. Active Contact Location
3.2.4. Stimulation Parameters
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Pat-ID | Sex | Age (y) | DD (y); FU (m) | Syndrome | Plus-Sign | BL-TRS | OFF-TRS | ON-TRS | % (BL) | % (OFF) | Clinical Stimulation Settings Left Hemisphere | Clinical Stimulation Settings Right Hemisphere |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | f | 78 | 9; 11 | ET | - | 27 | - | 9 | 66.67 | - | C+, 0–100%, 60 µs, 130 Hz, 2.5 mA | C+, 8–100%, 60 µs, 130 Hz, 1 mA |
2 | m | 67 | 37; 54 | ET | - | 16 | 20 | 5 | 68.75 | 75 | C+, 2–50%, 4–50%, 60 µs, 223 Hz, 2.5 mA | C+, 10–50%, 12–50%, 60 µs, 223 Hz, 2.2 mA |
3 | m | 71 | 39; 10 | ET | - | 22 | 21 | 3 | 86.36 | 85.71 | C+, 5–34%, 6–33%, 7–33%; 60 µs; 174 Hz; 2 mA | C+, 10–24%, 11–23%, 12–23%, 13–10%, 14–10%, 15–10%; 60 µs; 130 Hz; 1.3 mA |
4 | m | 26 | 9; 18 | ET | - | 14 | 3 | 1 | 92.86 | 66.67 | C+, 3–100%, 60 µs, 174 Hz, 1.3 mA | C+, 11–100%, 60 µs, 174 Hz, 0.7 mA |
5 | m | 56 | 46; 26 | ET | - | 17 | 71 | 9 | 47.06 | 87.32 | C+, 3–100%, 60 µs, 130 Hz, 3 mA | C+, 11–100%, 60 µs, 174 Hz, 2 mA |
6 | m | 72 | 11; 6 | ET | - | 26 | 19 | 3 | 88.46 | 84.21 | C+, 1–100%, 60μs, 130 Hz, 1.1 mA | C+, 9–100%, 60μs, 130 Hz, 1 mA |
7 | m | 64 | 32; 6 | ET | - | - | 23 | 7 | - | 69.57 | C+, 0–100%, 60 µs, 130 Hz, 2.0 V | C+, 8–100%, 60 µs, 130 Hz, 1.8 V |
8 | m | 68 | 30; 61 | ET | - | - | 33 | 14 | - | 57.58 | C+, 0–50%, 1–50%, 90μs, 150 Hz, 2 V | C+, 10–100%, 90μs, 150 Hz, 2.2 V |
9 | m | 60 | 44; 3 | ET | - | - | 30 | 18 | - | 40.0 | C+, 1–100%, 60 µs, 130 Hz, 1.6 mA | C+, 9–100%, 60 µs, 130 Hz, 1.7 mA |
10 | m | 53 | 44; 3 | ET | - | - | 17 | 7 | - | 58.82 | C+, 2–34%, 3–33%, 4–33%, 60 µs, 130 Hz, 1.4 mA | C+, 10–34%,11–33%, 12–33%, 60 µs, 130 Hz, 0.7 mA |
11 | m | 48 | 34; 67 | ET | - | - | 8 | 3 | - | 62.5 | VIM 1: C+, 1–0.3 V, 60μs, 120 Hz VIM 2:2–1.1 V, 60μs, 120 Hz | C+, 9–50%, 10–50%, 60μs, 120 Hz, 1.3 V |
12 | m | 62 | 29; 67 | ET | - | - | 35 | 6 | - | 82.86 | VIM 1: C+, 0–3.1 V, 60μs, 120 Hz VIM 2: C+, 1–1.3 V, 60 μs, 120 Hz | VIM 1: C+, 9–2.1 V, 60 μs, 120 Hz VIM 2:10–2.8 V, 60 μs, 120 Hz |
13 | m | 54 | 45; 18 | ET | - | - | 30 | 13 | - | 56.67 | C+, 2–34%, 3–33%, 4–33%, 204 Hz, 50 µs, 1.3 mA | C+, 10–34%, 11–33%, 12–33%, 204 Hz, 50 µs, 1.7 mA |
14 | f | 72 | 61; 12 | ET-p | RT | 34 | - | 3 | 91.18 | - | C+, 0–100%, 60 µs, 130 Hz, 2.2 V | C+, 8–100%, 60 µs, 130 Hz, 2.4 V |
15 | m | 22 | 13; 11 | ET-p | Dystonia, MCI | 51 | - | 21 | 58.82 | - | C+, 3–30% 4–60% 5–10%, 60 µs 174 Hz, 5.7 mA | C+, 11–25% 12–75%, 60 µs 174 Hz, 4 mA |
16 | f | 61 | 15; 11 | ET-p | RT, MCI | 37 | - | 20 | 45.95 | - | C+, 2–100%, 60 us, 130 Hz, 3.9 mA | C+, 10–100%, 60 us, 130 Hz, 3.9 mA |
17 | m | 60 | 29; 10 | ET-p | Dystonia | 21 | 32 | 10 | 52.38 | 68.75 | C+, 1–30%, 2–35%, 3–35%, 60 µs, 130 Hz, 1.9 mA | C+, 13–33%, 14–33%, 15–34%, 60 µs, 130 Hz, 1.6 mA |
18 | m | 66 | 16; 9 | ET-p | RT | 33 | 58 | 28 | 15.15 | 51.72 | C+, 1–100%, 60 µs, 208 Hz, 4.2 mA | C+, 11–100%, 60 µs, 208 Hz, 2.5 mA |
19 | m | 66 | 49; 43 | ET-p | Dystonia | 46 | 48 | 14 | 69.57 | 70.83 | C+, 3–100%, 60 µs, 130 Hz, 3.8 mA | C+, 11-, 100%, 60 µs, 130 Hz, 2.9 mA |
20 | f | 61 | 60; 4 | ET-p | MCI | 17 | 26 | 11 | 35.29 | 57.69 | C+, 2–100%, 60 μs, 130 Hz, 6.5 mA | C+, 10–100%, 60 μs, 130 Hz, 4 mA |
21 | m | 70 | 29; 5 | ET-p | RT, MCI | 16 | 21 | 11 | 31.25 | 47.62 | C+; 1–100%, 60 μs, 130 Hz, 1 mA | C+, 9–100%, 60 μs, 130 Hz, 1 mA |
22 | f | 63 | 21; 3 | ET-p | MCI | 15 | 20 | 4 | 73.33 | 80.0 | C+, 1–100%, 60 µs, 130 Hz, 1.4 mA | C+, 9–100%, 60 µs, 130 Hz, 1.2 mA |
23 | f | 77 | 27; 8 | ET-p | RT, MCI | 34 | 42 | 7 | 79.41 | 83.33 | C+, 1–62%, 2–14%, 3–12%, 4–12%, 50 µs, 174 Hz, 1.8 mA | C+, 9–75%, 10–9%, 11–8%, 12–8%, 50 µs, 174 Hz, 1.7 mA |
24 | f | 68 | 31; 31 | ET-p | RT, Ataxia | 18 | 25 | 6 | 66.67 | 76.0 | 2–70%, 3–30%, 5 + 100%, 60 µs, 174 Hz, 2.0 mA | 10–70%, 11–30%, 13 + 100%, 60 µs, 174 Hz, 2.0 mA |
25 | f | 70 | 56; 38 | ET-p | RT | - | 64 | 39 | - | 39.06 | C+, 1–100%, 60 us, 185 Hz, 2.8 mA | C+, 9–100%, 60 us, 185 Hz, 2.8 mA |
26 | m | 52 | 41; 98 | ET-p | MCI | - | 51 | 13 | - | 74.51 | C+, 1–100%, 60 µs, 200 Hz, 2.0 V | C+, 9–100%m, 60 µs, 200 Hz, 3.3 V |
27 | m | 77 | 16; 13 | ET-p | RT | - | 41 | 18 | - | 56.1 | C+, 1–100%, 60 µs, 200 Hz, 2.0 V | C+, 9–100%m, 60 µs, 200 Hz, 3.3 V |
28 | f | 75 | 10; 28 | ET-p | RT | - | 41 | 2 | - | 95.12 | C+, 2–100%, 60 µs, 125 Hz, 3.2 mA | VIM 1: C+, 8–50% 9–50%, 60 µs, 125 Hz, 3.6 mA Vim 2: C+, 9–100%, 60 µs, 125 Hz, 3.2 mA |
29 | m | 64 | 5; 15 | ET-p | Ataxia | - | 53 | 36 | - | 32.08 | 5 + 34%. 6 + 33%, 7 + 33%, 1–90%, 2–5%, 4–5% 40 µs, 204 Hz, 5 mA | 13 + 34%, 14 + 33%, 15 + 33%, 9–80%, 11–10%, 40 µs, 204 Hz, 4.7 mA |
30 | f | 65 | 24; 12 | ET-p | Ataxia | - | 33 | 5 | - | 84.85 | C+, 2–21%, 3–5%, 4–29%, 5–17%,6–5%,7–23%, 60 µs, 149 Hz, 2.3 mA | C+, 10–17%, 11–26%, 12–27%, 13–10%, 14–10%, 15–10%, 60 µs, 149 Hz, 2.3 mA |
31 | m | 58 | 11; 12 | ET-p | MCI | - | 47 | 22 | - | 53.19 | C+, 0–100%, 60 µs, 130 Hz, 3.3 V | C+, 8–100%, 60 µs, 130 Hz, 3.3 V |
32 | m | 69 | 6; 111 | ET-p | RT | - | 64 | 36 | - | 43.75 | C+, 0–100%, 60 µs, 180 Hz, 3.5 V | C+, 8–100%, 60 µs, 180 Hz, 3.1 V |
33 | f | 57 | 43; 32 | ET-p | Dystonia | - | 58 | 0 | - | 100.0 | VIM 1:C+; 2–100%, 2.4 V 90μs, 120 Hz VIM 2:3–100%, 90μs, 120 Hz, 1.8 V | C+, 10–100%, 60μs, 120 Hz, 2.8 V |
34 | m | 79 | 3; 37 | ET-p | MCI | - | 58 | 13 | - | 48.0 | C+, 1–100%, 80 µs, 149 Hz, 2.7 mA | C+, 9–100%, 60 µs, 149 Hz, 2.1 mA |
35 | m | 63 | 13; 17 | ET-p | Dystonia, ataxia | - | 54 | 7 | - | 87.04 | C+ 10%, 1–100%, 2 + 30%, 3 + 30%, 4 + 30%, 50 µs, 179 Hz, 2.8 mA | C+ 20%, 12–60%, 15–40%, 10 + 19%, 11 + 19%, 13 + 21%, 14 + 21%, G + 20%, 50 µs, 179 Hz, 3.5 mA |
36 | m | 63 | 44; 9 | ET-p | RT, dystonia | - | 52 | 28 | - | 46.15 | 1–100%, 2 + 34%, 3 + 33%, 4 + 33%, 60 µs, 179 Hz, 3.1 mA | 9–100%, 10 + 34%, 11 + 33%, 12 + 33%, 70 µs, 179 Hz, 3.4 mA |
37 | m | 75 | 66; 7 | ET-p | RT, MCI | - | 28 | 8 | - | 71.43 | C+, 2–34%, 3–33%, 4–33%, 60 µs, 130 Hz, 2.1 mA | C+, 2–34%, 3–33%, 4–33%, 60 µs, 130 Hz, 2.1 mA |
38 | m | 67 | 18; 8 | ET-p | Ataxia | - | 22 | 18 | - | 18.18 | - | - |
39 | f | 66 | 9; 14 | ET-p | Dystonia, MCI | - | 16 | 4 | - | 75.0 | VIM 1: C+, 8–100%, 90 µs, 125 Hz, 1.3 V VIM 2: C+, 9–100%, 90 µs, 125 Hz, 2.1 V | VIM 1: C+, 1–100%, 90 µs, 125 Hz, 2.1 V; VIM 2: C+, 0–100%, 90 µs, 125 Hz, 1.3 V |
40 | f | 77 | 47; 11 | ET-p | Dystonia | - | 16 | 7 | - | 56.25 | C+, 2–100%, 60 µs, 130 Hz, 3.6 mA | C+, 10–29%, 11–43%, 12–28%, 60 µs, 130 Hz, 1.9 mA |
41 | f | 80 | 20; 34 | ET-p | Dystonia, ataxia | - | 56 | 33 | - | 41.07 | C+, 5–32%, 6–29%, 7–29% 8–10% 40 µs 170 Hz 3.3 mA | C+, 13–45%, 14–40%, 15–15% 40 µs 170 Hz 4.1 mA |
42 | f | 70 | 7; 4 | ET-p | RT | - | 44 | 15 | - | 65.91 | C+, 1–100%, 60 µs, 130 Hz, 1.2 mA | C+, 9–100%, 60 µs, 130 Hz, 1.2 mA |
43 | m | 72 | 14; 25 | ET-p | RT | - | 64 | 25 | - | 60.94 | VIM1: C+, 2–100%, 60 us, 125 Hz, 2.9 VVIM 2: C+, 1–100%, 60 us, 125 Hz, 1.8 V | C+, 8-, 100%, 60 us, 125 Hz 3.0 |
44 | m | 55 | 10; 26 | ET-p | MCI | - | 39 | 0 | - | 51.28 | VIM 1: C+, 1–100%, 125 µs, 60 Hz, 0.5 V; VIM 2: C+, 2–100%, 125 µs, 60 Hz, 3.5 V | VIM1: C+, 9–100%, 125 µs, 60 Hz, 0.5 V VIM 2: C+, 10–100%, 125 µs, 60 Hz, 3.8 V |
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Steffen, J.K.; Jergas, H.; Petry-Schmelzer, J.N.; Dembek, T.A.; Thies, T.; Jost, S.T.; Dafsari, H.S.; Kessler, J.; Wirths, J.; Fink, G.R.; et al. Thalamic Deep Brain Stimulation in Essential Tremor Plus Is as Effective as in Essential Tremor. Brain Sci. 2020, 10, 970. https://doi.org/10.3390/brainsci10120970
Steffen JK, Jergas H, Petry-Schmelzer JN, Dembek TA, Thies T, Jost ST, Dafsari HS, Kessler J, Wirths J, Fink GR, et al. Thalamic Deep Brain Stimulation in Essential Tremor Plus Is as Effective as in Essential Tremor. Brain Sciences. 2020; 10(12):970. https://doi.org/10.3390/brainsci10120970
Chicago/Turabian StyleSteffen, Julia K., Hannah Jergas, Jan N. Petry-Schmelzer, Till A. Dembek, Tabea Thies, Stefanie T. Jost, Haidar S. Dafsari, Josef Kessler, Jochen Wirths, Gereon R. Fink, and et al. 2020. "Thalamic Deep Brain Stimulation in Essential Tremor Plus Is as Effective as in Essential Tremor" Brain Sciences 10, no. 12: 970. https://doi.org/10.3390/brainsci10120970
APA StyleSteffen, J. K., Jergas, H., Petry-Schmelzer, J. N., Dembek, T. A., Thies, T., Jost, S. T., Dafsari, H. S., Kessler, J., Wirths, J., Fink, G. R., Visser-Vandewalle, V., & Barbe, M. T. (2020). Thalamic Deep Brain Stimulation in Essential Tremor Plus Is as Effective as in Essential Tremor. Brain Sciences, 10(12), 970. https://doi.org/10.3390/brainsci10120970