Effect of thalamic deep brain stimulation on swallowing in patients with essential tremor

Ann Clin Transl Neurol. 2020 Jul;7(7):1174-1180. doi: 10.1002/acn3.51099. Epub 2020 Jun 16.

Abstract

Objective: Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) is a mainstay treatment for severe and drug-refractory essential tremor (ET). Although stimulation-induced dysarthria has been extensively described, possible impairment of swallowing has not been systematically investigated yet.

Methods: Twelve patients with ET and bilateral VIM-DBS with self-reported dysphagia after VIM-DBS were included. Swallowing function was assessed clinically and using by flexible endoscopic evaluation of swallowing in the stim-ON and in the stim-OFF condition. Presence, severity, and improvement of dysphagia were recorded.

Results: During stim-ON, the presence of dysphagia could be objectified in all patients, 42% showing mild, 42% moderate, and 16 % severe dysphagia. During stim-OFF, all patients experienced a statistically significant improvement of swallowing function.

Interpretation: VIM-DBS may have an impact on swallowing physiology in ET-patients. Further studies to elucidate the prevalence and underlying pathophysiological mechanisms are warranted.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Deep Brain Stimulation / adverse effects*
  • Deglutition Disorders / diagnosis*
  • Deglutition Disorders / etiology*
  • Essential Tremor / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Severity of Illness Index
  • Ventral Thalamic Nuclei*