Deep brain stimulation in essential tremor: targets, technology, and a comprehensive review of clinical outcomes

被引:39
作者
Wong, Joshua K. [1 ]
Hess, Christopher W. [1 ]
Almeida, Leonardo [1 ]
Middlebrooks, Erik H. [2 ]
Christou, Evangelos A. [3 ]
Patrick, Erin E. [4 ]
Shukla, Aparna Wagle [1 ]
Foote, Kelly D. [5 ]
Okun, Michael S. [1 ]
机构
[1] Univ Florida, Dept Neurol, Fixel Inst Neurol Dis, Gainesville, FL USA
[2] Mayo Clin, Dept Radiol, Jacksonville, FL 32224 USA
[3] Univ Florida, Dept Appl Physiol & Kinesiol, Gainesville, FL USA
[4] Univ Florida, Dept Elect & Comp Engn, Gainesville, FL USA
[5] Univ Florida, Fixel Inst Neurol Dis, Dept Neurosurg, Gainesville, FL USA
基金
美国国家卫生研究院;
关键词
Constant current; current steering; deep brain stimulation; segmented leads; essential tremor; posterior subthalamic area; ventralis intermedius nucleus; zona incerta; VENTRAL INTERMEDIATE NUCLEUS; LONG-TERM EFFICACY; THALAMIC-STIMULATION; PARKINSONS-DISEASE; MOVEMENT-DISORDER; CONSTANT-CURRENT; SUBTHALAMIC NEUROSTIMULATION; STEREOTAXIC THALAMOTOMY; MOTOR CORTEX; FOLLOW-UP;
D O I
10.1080/14737175.2020.1737017
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Introduction: Essential tremor (ET) is a common movement disorder with an estimated prevalence of 0.9% worldwide. Deep brain stimulation (DBS) is an established therapy for medication refractory and debilitating tremor. With the arrival of next generation technology, the implementation and delivery of DBS has been rapidly evolving. This review will highlight the current applications and constraints for DBS in ET. Areas covered: The mechanism of action, targets for neuromodulation, next generation guidance techniques, symptom-specific applications, and long-term efficacy will be reviewed. Expert opinion: The posterior subthalamic area and zona incerta are alternative targets to thalamic DBS in ET. However, they may be associated with additional stimulation-induced side effects. Novel stimulation paradigms and segmented electrodes provide innovative approaches to DBS programming and stimulation-induced side effects.
引用
收藏
页码:319 / 331
页数:13
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