Subthalamic stimulation for essential tremor. Short- and long-term results and critical target area.
OBJECTIVE
In order to explore the usefulness and long-term result of subthalamic nucleus (STN) stimulation for the treatment of essential tremor (ET), we evaluated 3 groups of patients undergoing deep brain stimulation (DBS) for ET.


RESULTS
Group 1 consisted of 3 patients who 9 years ago at intra-operative testing had good tremor reduction from STN stimulation. The second group consisted of 10 patients treated with DBS in the ventral intermediate (Vim) nucleus of the thalamus. The third group comprised 9 patients subjected to STN stimulation for ET with 1-3 years of follow-up. The 3 ET patients with STN stimulation in group 1 have continued to have excellent tremor reduction for up to 9 years. The second group, with Vim stimulation, showed less favourable long-term results. All of the recent STN stimulation group experienced good tremor reduction, but some of the patients above 70 years of age reported troublesome side effects.


CONCLUSIONS
Provided that intra-operative test stimulation produces satisfactory tremor control, STN is a good target for long-term treatment of ET. For patients above the age of 70 years, however, the Vim is a preferable target.
Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden. goran.lind@karolinska.se
Göran
G
Lind
Gaston
G
Schechtmann
Charlotta
C
Lind
Jaleh
J
Winter
Björn A
BA
Meyerson
Bengt
B
Linderoth
D000368:Aged; D000369:Aged, 80 and over; D046690:Deep Brain Stimulation / Q000379:methods*; D020329:Essential Tremor / Q000503:physiopathology* / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000523:psychology; D020531:Subthalamic Nucleus / Q000502:physiology*; D013995:Time