Differentiating Postural and Kinetic Tremor Responses to Deep Brain Stimulation in Essential Tremor.

Autor: Butler RD; Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA., Brinda AK; Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA., Blumenfeld M; Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA., Bryants MN; Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA., Grund PM; Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA., Pandey SR; Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA., Cornish CKS; Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA., Sullivan D; Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA., Krieg J; Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA., Umoh M; Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA., Vitek JL; Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA., Almeida L; Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA., Orcutt T; Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA., Cooper SE; Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA., Johnson MD; Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA.
Jazyk: angličtina
Zdroj: Movement disorders clinical practice [Mov Disord Clin Pract] 2024 Nov 07. Date of Electronic Publication: 2024 Nov 07.
DOI: 10.1002/mdc3.14256
Abstrakt: Background: While deep brain stimulation (DBS) targeting the ventral intermediate nucleus (VIM) of thalamus or posterior subthalamic area (PSA) can suppress forms of action tremor in people with Essential Tremor, previous studies have suggested postural tremor may respond more robustly than kinetic tremor to DBS.
Objectives: In this study, we aimed to more precisely quantify the (1) onset/offset dynamics and (2) steady-state effects of VIM/PSA-DBS on postural and kinetic tremor.
Methods: Tremor data from wireless inertial measurement units were collected from 11 participants with ET (20 unilaterally assessed DBS leads). Three postural hold tasks and one kinetic task were performed with stimulation turned off, in 2-min intervals after enabling unilateral DBS at the clinician-optimized DBS setting (15 min), and in 2-min intervals following cessation of DBS (5 min).
Results: At baseline, kinetic tremor had significantly higher amplitudes, standard deviation, and frequency than postural tremor (P < 0.001). DBS had a more robust acute effect on postural tremors (54% decrease, P < 0.001), with near immediate tremor suppression in amplitude and standard deviation, but had non-significant improvement of kinetic tremor on the population-level across the wash-in period (34% decrease). Tremor response was not equivalent between wash-in and wash-out timepoints and involved substantial individual variability including task-specific rebound or long wash-out effects.
Conclusions: Programming strategies for VIM/PSA-DBS should consider the individual temporal and effect size variability in postural versus kinetic tremor improvement. Improved targeting and programming strategies around VIM and PSA may be necessary to equivalently suppress both postural and kinetic tremors.
(© 2024 The Author(s). Movement Disorders Clinical Practice published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.)
Databáze: MEDLINE
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