Primary orthostatic tremor: is deep brain stimulation better than spinal cord stimulation?

2017 ◽  
Vol 88 (9) ◽  
pp. 804-805 ◽  
Author(s):  
Han-Lin Chiang ◽  
Yi-Cheng Tai ◽  
Jacqueline McMaster ◽  
Victor SC Fung ◽  
Neil Mahant
Keyword(s):  
Spinal Cord ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Spinal Cord Stimulation ◽  
Orthostatic Tremor ◽  
Better Than ◽  
Deep Brain

scholarly journals Ultrahigh Frequency Deep Brain Stimulation at 10 000 Hz Improves Motor Function

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Irene E Harmsen ◽  
Darrin J Lee ◽  
Robert F Dallapiazza ◽  
Philippe De Vloo ◽  
Robert Chen ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Deep Brain Stimulation ◽  
Adverse Effects ◽  
Brain Stimulation ◽  
Spinal Cord Stimulation ◽  
Ultrahigh Frequency ◽  
Clinical Effects ◽  
Stimulation Parameters ◽  
Clinical Benefits ◽  
Deep Brain

Abstract INTRODUCTION Stimulation frequency has been considered a crucial determinant of efficacy in deep brain stimulation (DBS). DBS at frequencies over 250 Hz is not currently employed and consensus in the field suggests that higher frequencies are not clinically effective. With the recent demonstration of clinically effective ultrahigh frequency (UHF) spinal cord stimulation at 10 kHz we tested whether UHF stimulation could also be clinically useful in movement disorder patients with DBS. We evaluated the clinical effects and safety of UHF DBS in patients with subthalamic nucleus (STN) or ventral intermediate thalamic nucleus (VIM) DBS. METHODS We studied the effects of conventional (130 Hz) and UHF stimulation in 5 patients with Parkinson's disease (PD) with STN DBS and in one patient with essential tremor (ET) with VIM DBS. We compared the clinical benefit and adverse effects of stimulation at various amplitudes either intraoperatively or postoperatively with the electrodes externalized. RESULTS Motor performance improved in all 6 patients with UHF DBS. About 10 kHz stimulation at amplitudes = 3.0 mA appeared to be as effective as 130 Hz in improving motor symptoms (46.2% vs 53.5% motor score reduction, P = .110, N = 90 trials). Interestingly, 10 kHz stimulation resulted in fewer stimulation-induced paresthesiae and speech adverse effects than 130 Hz stimulation. CONCLUSION Our results indicate that DBS at 10 kHz produces clinical benefits in patients with movement disorders. Like 10 kHz spinal cord stimulation, 10 kHz DBS has the potential to produce clinical benefits while possibly reducing stimulation-induced adverse effects. Further studies will be required to optimize UHF DBS stimulation parameters and to determine its clinical utility.

Spinal cord stimulation improves gait in patients with Parkinson's disease previously treated with deep brain stimulation

2016 ◽  
Vol 32 (2) ◽  
pp. 278-282 ◽  
Author(s):  
Carolina Pinto de Souza ◽  
Clement Hamani ◽  
Carolina Oliveira Souza ◽  
William Omar Lopez Contreras ◽  
Maria Gabriela dos Santos Ghilardi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Spinal Cord ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Spinal Cord Stimulation ◽  
Previously Treated ◽  
Deep Brain

Deep Brain Stimulation and Spinal Cord Stimulation for Vegetative State and Minimally Conscious State

2013 ◽  
Vol 80 (3-4) ◽  
pp. S30.e1-S30.e9 ◽  
Author(s):  
Takamitsu Yamamoto ◽  
Yoichi Katayama ◽  
Toshiki Obuchi ◽  
Kazutaka Kobayashi ◽  
Hideki Oshima ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Spinal Cord Stimulation ◽  
Vegetative State ◽  
Minimally Conscious State ◽  
Conscious State ◽  
Minimally Conscious ◽  
Deep Brain

Neuromodulation for Medically Refractory Neuropathic Pain: Spinal Cord Stimulation, Deep Brain Stimulation, Motor Cortex Stimulation, and Posterior Insula Stimulation

2021 ◽  
Vol 146 ◽  
pp. 246-260
Author(s):  
Giovanna Zambo Galafassi ◽  
Pedro Henrique Simm Pires de Aguiar ◽  
Renata Faria Simm ◽  
Paulo Roberto Franceschini ◽  
Marco Prist Filho ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Deep Brain Stimulation ◽  
Motor Cortex ◽  
Brain Stimulation ◽  
Spinal Cord Stimulation ◽  
Motor Cortex Stimulation ◽  
Posterior Insula ◽  
Deep Brain

scholarly journals The continued relevance of Deep Brain Stimulation for chronic pain

2021 ◽  
Vol 6 (1) ◽  
pp. 009-014
Author(s):  
Farrell Sarah Marie ◽  
Aziz Tipu
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Spinal Cord Stimulation ◽  
Success Rates ◽  
Off Label ◽  
The Past ◽  
Variable Success ◽  
Deep Brain

For the millions of patients experiencing chronic pain despite pharmacotherapy, deep brain stimulation (DBS) provides a beacon of hope. Over the past decade the field has shifted away from DBS towards other forms of neuromodulation, particularly spinal cord stimulation (SCS). DBS for pain is still performed, albeit off-label in US and UK, and experiences variable success rates. SCS is an extremely useful tool for the modulation of pain but is limited in its application to specific pain aetiologies. We advocate use of DBS for pain, for patients for whom pharmacology has failed and for whom spinal cord stimulation is inadequate. DBS for chronic pain is at risk of premature neglect. Here we outline how this has come to pass, and in the process argue for the untapped potential for this procedure.

Deep brain stimulation of the ventral intermediate nucleus of the thalamus in medically refractory orthostatic tremor: Preliminary observations

2008 ◽  
Vol 23 (16) ◽  
pp. 2357-2362 ◽  
Author(s):  
Alberto J. Espay ◽  
Andrew P. Duker ◽  
Robert Chen ◽  
Michael S. Okun ◽  
Edwin T. Barrett ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Orthostatic Tremor ◽  
Intermediate Nucleus ◽  
Ventral Intermediate Nucleus ◽  
Deep Brain ◽  
Stimulation Of

scholarly journals Deep brain stimulation for orthostatic tremor

2019 ◽  
Vol 10 (4) ◽  
pp. 324-332 ◽  
Author(s):  
Angela L. Hewitt ◽  
Bryan T. Klassen ◽  
Kendall H. Lee ◽  
Jamie J. Van Gompel ◽  
Anhar Hassan
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Case Reports ◽  
Weight Bearing ◽  
Clinical Electrophysiology ◽  
Onset Latency ◽  
Meaningful Improvement ◽  
Standing Time ◽  
Orthostatic Tremor ◽  
Deep Brain

BackgroundOrthostatic tremor (OT) is a high-frequency weight-bearing tremor of the legs and trunk associated with progressive disability and is often refractory to medications. Case reports suggest that thalamic deep brain stimulation (DBS) is effective. We report 5 female patients with medication-refractory OT who underwent bilateral thalamic DBS at the Mayo Clinic and assess factors associated with a successful DBS outcome.MethodsDemographic, clinical, electrophysiology, and DBS data were abstracted. Outcomes were change in tremor-onset latency, standing time, standing ADLs, and patient and clinician global impression of change (PGIC; CGIC).ResultsAll 5 patients had improved standing time (72 vs 408 seconds, p ≤ 0.001) and improved standing ADLs after surgery, without change in tremor-onset latency (16 vs 75 seconds, p = 0.14). Maximal benefit was reached up to 3 years after surgery and sustained for up to 6 years. CGIC was “much improved” in all; PGIC was “much improved” in 4 and “minimally improved” in 1. There were no major complications. Postoperative electrophysiology (n = 1) showed lower tremor amplitude and slower tremor ramp-up on vs off stimulation.ConclusionsBilateral thalamic DBS improved OT symptoms with benefit lasting up to 6 years. A modest increase in standing time of several minutes was associated with meaningful improvement in standing ADLs. Microlesional effect and bilateral stimulation are likely favorable features, while baseline standing time of several minutes may be unfavorable. These findings may inform clinician and patient counseling and require confirmation in larger studies.

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