Deep Brain Stimulation for Tremor: Update on Long-Term Outcomes, Target Considerations and Future Directions
Deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus is one of the main advanced neurosurgical treatments for drug-resistant tremor. However, not every patient may be eligible for this procedure. Nowadays, various other functional neurosurgical procedures are available. In parti...
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| Veröffentlicht in: | Journal of clinical medicine 2021-08, Vol.10 (16), p.3468 |
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| container_title | Journal of clinical medicine |
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| creator | Kremer, Naomi I. Pauwels, Rik W. J. Pozzi, Nicolò G. Lange, Florian Roothans, Jonas Volkmann, Jens Reich, Martin M. |
| description | Deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus is one of the main advanced neurosurgical treatments for drug-resistant tremor. However, not every patient may be eligible for this procedure. Nowadays, various other functional neurosurgical procedures are available. In particular cases, radiofrequency thalamotomy, focused ultrasound and radiosurgery are proven alternatives to DBS. Besides, other DBS targets, such as the posterior subthalamic area (PSA) or the dentato-rubro-thalamic tract (DRT), may be appraised as well. In this review, the clinical characteristics and pathophysiology of tremor syndromes, as well as long-term outcomes of DBS in different targets, will be summarized. The effectiveness and safety of lesioning procedures will be discussed, and an evidence-based clinical treatment approach for patients with drug-resistant tremor will be presented. Lastly, the future directions in the treatment of severe tremor syndromes will be elaborated. |
| doi_str_mv | 10.3390/jcm10163468 |
| format | Article |
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J. ; Pozzi, Nicolò G. ; Lange, Florian ; Roothans, Jonas ; Volkmann, Jens ; Reich, Martin M.</creator><creatorcontrib>Kremer, Naomi I. ; Pauwels, Rik W. J. ; Pozzi, Nicolò G. ; Lange, Florian ; Roothans, Jonas ; Volkmann, Jens ; Reich, Martin M.</creatorcontrib><description>Deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus is one of the main advanced neurosurgical treatments for drug-resistant tremor. However, not every patient may be eligible for this procedure. Nowadays, various other functional neurosurgical procedures are available. In particular cases, radiofrequency thalamotomy, focused ultrasound and radiosurgery are proven alternatives to DBS. Besides, other DBS targets, such as the posterior subthalamic area (PSA) or the dentato-rubro-thalamic tract (DRT), may be appraised as well. In this review, the clinical characteristics and pathophysiology of tremor syndromes, as well as long-term outcomes of DBS in different targets, will be summarized. The effectiveness and safety of lesioning procedures will be discussed, and an evidence-based clinical treatment approach for patients with drug-resistant tremor will be presented. Lastly, the future directions in the treatment of severe tremor syndromes will be elaborated.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm10163468</identifier><identifier>PMID: 34441763</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Clinical medicine ; Deep brain stimulation ; Dopamine ; Gait ; Parkinson's disease ; Pathophysiology ; Patients ; Physiology ; Posture ; Quality of life ; Review ; Surgery ; Tremor (Muscular contraction)</subject><ispartof>Journal of clinical medicine, 2021-08, Vol.10 (16), p.3468</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. 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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; PubMed Central |
| subjects | Clinical medicine Deep brain stimulation Dopamine Gait Parkinson's disease Pathophysiology Patients Physiology Posture Quality of life Review Surgery Tremor (Muscular contraction) |
| title | Deep Brain Stimulation for Tremor: Update on Long-Term Outcomes, Target Considerations and Future Directions |
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