Role of Directional Configuration in Deep Brain Stimulation for Essential Tremor: A Single Center Experience
| Autor: | Amie L. Hiller, Delaram Safarpour, Venka Veerappan, Shannon Anderson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Deep brain stimulation Side effect Adolescent medicine.medical_treatment Deep Brain Stimulation Essential Tremor Stimulation Single Center Dysarthria Young Adult Physical medicine and rehabilitation Tremor medicine Humans Child Retrospective Studies Essential tremor Ventral intermediate nucleus business.industry Brief Report Middle Aged medicine.disease directional configuration Child Preschool Gait Ataxia medicine.symptom business |
| Zdroj: | Tremor and Other Hyperkinetic Movements |
| ISSN: | 2160-8288 |
| Popis: | Background: Traditionally, the standard of care for medication refractory essential tremor has been to utilize omnidirectional deep brain stimulation of the ventral intermediate nucleus. The advent of directional stimulation allows for spatial restriction of the stimulation on selected targets without involving the neighboring structures, thereby limiting off-target side effects and improving clinical utility. Methods: We performed a retrospective review of patients between February 2017 and September 2019 who had received ventral intermediate nucleus deep brain stimulation that allowed for directional programming (specifically Abbott/St. Jude). Initial and final major programming sessions post-operatively (approximately 30- and 90-days post-surgery) were examined to determine frequency and reason for use of directional programming. Results: A total of 33 total patients were identified. A little over half were males (58%, N = 19), with an average age of 68 years old (SD 9.3) at the time of surgery, and a disease duration of almost 30 years (27.2, SD 19) with a wide range from 2–62 years. After initial programming, over 50% (17 of 33) of patients were using directional configurations. This increased to 85% (28 of 33) at the 90-day programming. Reasons for conversion to directional configuration included avoidance of side effects (specifically, muscle contractions (9/33), paresthesia (5/33), dysarthria (1/33) and gait ataxia (1/33)) or improved tremor control (12/33). Discussion: Our single-center experience suggests that in the large majority of cases, directional leads were utilized and offered advantages in tremor control or side effect avoidance. |
| Databáze: | OpenAIRE |
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