BACKGROUND: Deep brain stimulation (DBS) offers a non-ablative alternative to thalamotomy for the surgical treatment of medically refractory tremor in multiple sclerosis. However, relatively few outcomes have been reported. OBJECTIVE: To provide a systematic review of the published cases of DBS use in multiple sclerosis and to present four additional patients. METHODS: Quantitative and qualitative review of the published reports and description of a case series from one centre. RESULTS: In the majority of reported cases (n=75), the surgical target for DBS implantation was the ventrointeromedial nucleus of the thalamus. Tremor reduction and improvement in daily functioning were achieved in most patients, with 87.7% experiencing at least some sustained improvement in tremor control postsurgery. Effects on daily functioning were less consistently assessed across studies; in papers reporting relevant data, 76.0% of patients experienced improvement in daily functioning. Adverse effects were similar to those reported for DBS in other patient populations. CONCLUSIONS: Few of the studies reviewed used highly standardised quantitative outcome measures, and follow up periods were generally one year or less. Nonetheless, the data suggest that chronic DBS often produces improved tremor control in multiple sclerosis. Complete cessation of tremor is not necessarily achieved, there are cases in which tremor control decreases over time, and frequent reprogramming appears to be necessary.
BACKGROUND: Deep brain stimulation (DBS) offers a non-ablative alternative to thalamotomy for the surgical treatment of medically refractory tremor in multiple sclerosis. However, relatively few outcomes have been reported. OBJECTIVE: To provide a systematic review of the published cases of DBS use in multiple sclerosis and to present four additional patients. METHODS: Quantitative and qualitative review of the published reports and description of a case series from one centre. RESULTS: In the majority of reported cases (n=75), the surgical target for DBS implantation was the ventrointeromedial nucleus of the thalamus. Tremor reduction and improvement in daily functioning were achieved in most patients, with 87.7% experiencing at least some sustained improvement in tremor control postsurgery. Effects on daily functioning were less consistently assessed across studies; in papers reporting relevant data, 76.0% of patients experienced improvement in daily functioning. Adverse effects were similar to those reported for DBS in other patient populations. CONCLUSIONS: Few of the studies reviewed used highly standardised quantitative outcome measures, and follow up periods were generally one year or less. Nonetheless, the data suggest that chronic DBS often produces improved tremor control in multiple sclerosis. Complete cessation of tremor is not necessarily achieved, there are cases in which tremor control decreases over time, and frequent reprogramming appears to be necessary.
Authors: D Nandi; M Chir; X Liu; P Bain; S Parkin; C Joint; J Winter; J Stein; R Scott; R Gregory; T Aziz Journal: J Clin Neurosci Date: 2002-01 Impact factor: 1.961
Authors: J Matsumoto; D Morrow; K Kaufman; D Davis; J E Ahlskog; A Walker; D Sneve; J Noseworthy; M Rodriguez Journal: Neurology Date: 2001-11-27 Impact factor: 9.910
Authors: P R Schuurman; D A Bosch; P M Bossuyt; G J Bonsel; E J van Someren; R M de Bie; M P Merkus; J D Speelman Journal: N Engl J Med Date: 2000-02-17 Impact factor: 91.245
Authors: M Lefranc; M Manto; P Merle; M Tir; D Montpellier; J-M Constant; D Le Gars; J-M Macron; P Krystkowiak Journal: Cerebellum Date: 2014-06 Impact factor: 3.847
Authors: João Carlos Correia de Sa; Laura Airas; Emmanuel Bartholome; Nikolaos Grigoriadis; Heinrich Mattle; Celia Oreja-Guevara; Jonathan O'Riordan; Finn Sellebjerg; Bruno Stankoff; Karl Vass; Agata Walczak; Heinz Wiendl; Bernd C Kieseier Journal: Ther Adv Neurol Disord Date: 2011-05 Impact factor: 6.570
Authors: Pawan V Rawal; Leonardo Almeida; Luke B Smelser; He Huang; Barton L Guthrie; Harrison C Walker Journal: Brain Stimul Date: 2014-01-18 Impact factor: 8.955