Deep brain stimulation for tremor resulting from acquired brain injury

H A Sitsapesan; P Holland; Z Oliphant; N De Pennington; J-S Brittain; N Jenkinson; C Joint; T Z Aziz; A L Green

doi:10.1136/jnnp-2013-305340

Deep brain stimulation for tremor resulting from acquired brain injury

J Neurol Neurosurg Psychiatry. 2014 Jul;85(7):811-5. doi: 10.1136/jnnp-2013-305340. Epub 2013 Dec 4.

Authors

H A Sitsapesan¹, P Holland¹, Z Oliphant², N De Pennington³, J-S Brittain⁴, N Jenkinson¹, C Joint⁵, T Z Aziz¹, A L Green¹

Affiliations

¹ Oxford Functional Neurosurgery and Experimental Neurology, Oxford University, Oxford, Oxfordshire, UK Nuffield Department of Surgical Sciences, Oxford University, Oxford, Oxfordshire, UK.
² Department of Physiology, Anatomy and Genetics, Oxford University, Oxford, Oxfordshire, UK.
³ Oxford Functional Neurosurgery and Experimental Neurology, Oxford University, Oxford, Oxfordshire, UK Department of Physiology, Anatomy and Genetics, Oxford University, Oxford, Oxfordshire, UK.
⁴ Oxford Functional Neurosurgery and Experimental Neurology, Oxford University, Oxford, Oxfordshire, UK Oxford University, Institute for Biomedical Engineering, Oxford, Oxfordshire, UK.
⁵ Oxford Functional Neurosurgery and Experimental Neurology, Oxford University, Oxford, Oxfordshire, UK.

PMID: 24306513
DOI: 10.1136/jnnp-2013-305340

Abstract

Objectives: To evaluate the efficacy of deep brain stimulation (DBS) in the treatment of tremor resulting from acquired brain injury (ABI).

Methods: A series of eight consecutive patients with post-ABI tremor were treated with DBS of the ventro-oralis posterior (VOP)/zona incerta (ZI) region, and subsequently underwent blinded assessments using Bain's tremor severity scale.

Results: VOP/ZI DBS produced a mean reduction in tremor severity of 80.75% based on Bain's tremor severity scale, with significant reductions in all five component tremor subscores: rest, postural, kinetic, proximal and distal. No adverse neurological complications were reported, although one patient experienced exacerbation of pre-existing gait ataxia.

Conclusion: VOP/ZI stimulation is demonstrated here to be an effective and safe approach for the treatment of post-ABI tremor in the largest series published at the time of writing.

Keywords: Electrical Stimulation; Head Injury; Movement Disorders; Neurosurgery; Tremor.

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Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Brain Injuries / complications*
Deep Brain Stimulation* / adverse effects
Deep Brain Stimulation* / methods
Electrodes, Implanted
Female
Humans
Male
Severity of Illness Index
Single-Blind Method
Treatment Outcome
Tremor / etiology
Tremor / therapy*
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding