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Bilateral Subthalamic Deep Brain Stimulation in Parkinson Disease Patients With Severe Tremor

Cited 18 time in Web of Science Cited 16 time in Scopus
Authors
Kim, Han-Joon; Jeon, Beom S.; Paek, Sun Ha; Lee, Jee-Young; Kim, Chi Kyung; Kim, Dong Gyu; Kim, Hee Jin
Issue Date
2010-09
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
NEUROSURGERY; Vol.67 3; 626-632
Keywords
Deep brain stimulationParkinson diseaseSubthalamic nucleusTremor
Abstract
BACKGROUND: Previous studies have shown that subthalamic nucleus (STN) deep brain stimulation (DBS) improves tremor in Parkinson disease (PD). However, the patients included in those studies were unselected for tremor severity. OBJECTIVE: We specifically assessed the effect of STN DBS on tremor in selected PD patients with severe tremor. METHODS: Seventy-two PD patients who had received bilateral STN DBS were included. The effects of STN DBS on the off-medication tremor, the on-medication tremor, and the off-medication action tremor in patients selected as the worst one-third in each category at baseline were evaluated after a mean duration of > 2 years. RESULTS: In patients with severe off-medication tremor, off-medication tremor score improved from 12.28 +/- 2.80 at baseline to 1.93 +/- 2.85 at the last follow-up (P < .001). The off-medication tremor in the off-stimulation state at the last follow-up was less severe than the preoperative off-medication tremor. In patients with severe on-medication tremor, on-medication tremor score improved from 6.17 +/- 2.45 to 1.35 +/- 2.58 (P < .001). In patients with severe off-medication action tremor, off-medication action tremor score improved from 5.08 +/- 1.35 to 1.24 +/- 1.42 (P < .001). CONCLUSION: STN DBS is effective for severe off-and on-medication tremor and off-medication action tremor in PD. Our findings suggest that STN DBS reduces PD tremor through, at least in part, its effect on the tremor-generating mechanism independent of dopaminergic transmission and that long-term electrical stimulation of STN might induce a structural or neurochemical change leading to the improvement of tremor.
ISSN
0148-396X
Language
English
URI
http://hdl.handle.net/10371/77116
DOI
https://doi.org/10.1227/01.NEU.0000374850.98949.D4
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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