title: Deep brain stimulation in the ventrolateral thalamus/subthalamic area in dystonia with head tremor.
abstract: BACKGROUND
  Pallidal deep brain stimulation (GPi-DBS) effectively ameliorates idiopathic dystonia, although approximately 15% of patients respond insufficiently. Although various thalamic and subthalamic targets have been suggested for dystonic tremor, no systematic studies have been published on thalamic DBS in dystonic tremor. We assessed the effect of thalamic/subthalamic area DBS (Th-DBS) on dystonic head tremor and dystonia in a single-blind design.
  
  
  METHODS
  Dystonic head tremor and dystonia before and 3 months after surgery were quantified via blinded video-ratings using the Fahn-Tolosa-Marin-Tremor-Scale and the Burke-Fahn-Marsden-Dystonia-Rating-Scale in seven patients with idiopathic cervical or segmental dystonia, dystonic head tremor, and bilateral Th-DBS. Pain, side effects, adverse events, and stimulation parameters were assessed.
  
  
  RESULTS
  Th-DBS improved dystonic tremor and dystonia (P < 0.05; 57.1% and 70.4%, respectively). Head tremor amplitude and pain were also improved (P < 0.05; 77.5% and 90.0%, respectively). Side effects included dysarthria, gait disturbance, slowness of movement, and weight gain.
  
  
  CONCLUSIONS
  Dystonic head tremor and dystonia can be improved with Th-DBS.
authors.affiliation: Department of Neurology, University Hospital Cologne, University of Cologne, Cologne, Germany.
authors.forename: K Amande M
authors.initials: KA
authors.lastname: Pauls
authors.forename: Sven
authors.initials: S
authors.lastname: Hammesfahr
authors.forename: Elena
authors.initials: E
authors.lastname: Moro
authors.forename: A Peter
authors.initials: AP
authors.lastname: Moore
authors.forename: Ellen
authors.initials: E
authors.lastname: Binder
authors.forename: Faycal
authors.initials: F
authors.lastname: El Majdoub
authors.forename: Gereon R
authors.initials: GR
authors.lastname: Fink
authors.forename: Volker
authors.initials: V
authors.lastname: Sturm
authors.forename: Joachim K
authors.initials: JK
authors.lastname: Krauss
authors.forename: Mohammad
authors.initials: M
authors.lastname: Maarouf
authors.forename: Lars
authors.initials: L
authors.lastname: Timmermann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046690:Deep Brain Stimulation; D004421:Dystonia / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D020531:Subthalamic Nucleus / Q000503:physiopathology*; D016896:Treatment Outcome; D014202:Tremor / Q000209:etiology / Q000628:therapy*; D020651:Ventral Thalamic Nuclei / Q000503:physiopathology*; D055815:Young Adult
keywords: dystonic tremor; kinematic tremor analysis; pain; treatment