title: Vocal Tremor: Novel Therapeutic Target for Deep Brain Stimulation.
abstract: Tremulous voice is characteristically associated with essential tremor, and is referred to as essential vocal tremor (EVT). Current estimates suggest that up to 40% of individuals diagnosed with essential tremor also present with EVT, which is associated with an impaired quality of life. Traditional EVT treatments have demonstrated limited success in long-term management of symptoms. However, voice tremor has been noted to decrease in patients receiving deep brain stimulation (DBS) with the targeting of thalamic nuclei. In this study, we describe our multidisciplinary procedure for awake, frameless DBS with optimal stimulation targets as well as acoustic analysis and laryngoscopic assessment to quantify tremor reduction. Finally, we investigate the most recent clinical evidence regarding the procedure.
authors.affiliation: Department of Neurosurgery, Stanford University, 300 Pasteur Dr., Edwards Bldg. R-293, Stanford, CA 94305, USA. vinod.rr@gmail.com.
authors.forename: Vinod K
authors.initials: VK
authors.lastname: Ravikumar
authors.affiliation: Department of Neurosurgery, Stanford University, 300 Pasteur Dr., Edwards Bldg. R-293, Stanford, CA 94305, USA. aho5@stanford.edu.
authors.forename: Allen L
authors.initials: AL
authors.lastname: Ho
authors.affiliation: Department of Neurosurgery, Stanford University, 300 Pasteur Dr., Edwards Bldg. R-293, Stanford, CA 94305, USA. parkerjo@stanford.edu.
authors.forename: Jonathon J
authors.initials: JJ
authors.lastname: Parker
authors.affiliation: Department of Neurosurgery, Stanford University, 300 Pasteur Dr., Edwards Bldg. R-293, Stanford, CA 94305, USA. edirenzo@ohns.stanford.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Erickson-DiRenzo
authors.affiliation: Department of Neurosurgery, Stanford University, 300 Pasteur Dr., Edwards Bldg. R-293, Stanford, CA 94305, USA. chalpern@stanford.edu.
authors.forename: Casey H
authors.initials: CH
authors.lastname: Halpern
keywords: EVT; VIM; acoustic analysis; awake DBS; deep brain stimulation; dysphonia; essential tremor; essential vocal tremor; laryngoscopy; microelectrode recording; tremulous voice; ventral intermediate nucleus; voice