Robert E Wharen1, Michael S Okun2, Barton L Guthrie3, Ryan J Uitti4, Paul Larson5, Kelly Foote6, Harrison Walker7, Frederick J Marshall8, Jason Schwalb9, Blair Ford10, Joseph Jankovic11, Richard Simpson12, Khashayar Dashtipour13, Fenna Phibbs14, Joseph S Neimat15, R Malcolm Stewart16, DeLea Peichel17, Rajesh Pahwa18, Jill L Ostrem19. 1. Department of Neurologic Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, United States. Electronic address: wharen.robert@mayo.edu. 2. Departments of Neurology and Neurosurgery, University of Florida College of Medicine and McKnight Brain Institute, University of Florida Center for Movement Disorders and Neurorestoration, 3450 Hull Road, 4th Floor, Gainesville, FL 32607, United States. Electronic address: okun@neurology.ufl.edu. 3. Department of Neurosurgery, University of Alabama Birmingham, School of Medicine, Department of Neurosurgery, 510 20th Avenue South, FOT 1038, Birmingham, AL 35234, United States. Electronic address: bguthrie@uabmc.edu. 4. Department of Neurology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, United States. Electronic address: Uitti.ryan@mayo.edu. 5. Department of Neurological Surgery, University of California San Francisco, 1635 Divisadero Street, 5th Floor, Suite 520-530, San Francisco, CA 94115, United States. Electronic address: LarsonP@neurosurg.ucsf.edu. 6. Departments of Neurological Surgery, University of Florida College of Medicine and McKnight Brain Institute, University of Florida Center for Movement Disorders and Neurorestoration, 3450 Hull Road, 4th Floor, Gainesville, FL 32607, United States. Electronic address: foote@neurosurgery.ufl.edu. 7. Department of Neurology, University of Alabama Birmingham, School of Medicine, 510 20th Avenue South, FOT 1038, Birmingham, AL 35234, United States. Electronic address: hcwalker@uab.edu. 8. Neurology Department, University of Rochester, 919 Westfall Rd., Bldg C, Suite 220, Rochester, NY 14618, United States. Electronic address: Fred.Marshall@ctcc.rochester.edu. 9. Movement Disorder and Comprehensive Epilepsy Centers, Henry Ford Medical Group, 6777 West Maple Road, West Bloomfield, MI 48322, United States. Electronic address: jschwal1@hfhs.org. 10. Movement Disorder Group, Columbia University Medical Center, 710 West 168th Street, 3rd Floor, #350, New York, NY 10032, United States. Electronic address: BFord@neuro.columbia.edu. 11. Department of Neurology, Baylor College of Medicine, 6550 Fannin Street, Suite 1801, Houston, TX 77030, United States. Electronic address: josephj@bcm.tmc.edu. 12. Department of Neurosurgery, The Methodist Hospital Physician Organization, 6560 Fannin, Suite 944, Houston, TX 77030, United States. Electronic address: RSimpson@houstonmethodist.org. 13. Department of Neurology, Loma Linda University Medical Center, Division of Movement Disorders, 11370 Anderson St, Suite 2400, Loma Linda, CA 92354, United States. Electronic address: KDashtipour@llu.edu. 14. Department of Neurology, Vanderbilt University, A-0118 Medical Center North, Nashville, TN 37232-2551, United States. Electronic address: fenna.phibbs@Vanderbilt.edu. 15. Department of Neurosurgery, Vanderbilt University, 1211 22nd Ave. S, Nashville, TN 37232, United States. Electronic address: joseph.neimat@Vanderbilt.edu. 16. Movement Disorder Center, Texas Health Presbyterian Dallas, 8200 Walnut Hill, Dallas, TX 75231, United States. Electronic address: stewart4765@sbcglobal.net. 17. Clinical Research Department, St. Jude Medical, 6901 Preston Road, Plano, TX 75024, United States. Electronic address: dpeichel@sjm.com. 18. Parkinson's Disease and Movement Disorder Center, University of Kansas Medical Center, 3599 Rainbow Blvd, Mailstop 2012, Kansas City, KS 66160, United States. Electronic address: RPAHWA@kumc.edu. 19. Surgical Movement Disorders, Department of Neurology, University of California San Francisco and the San Francisco Veteran's Affairs Medical Center, 1635 Divisadero Street, 5th Floor, Suite 520-530, San Francisco, CA 94115, United States. Electronic address: jill.ostrem@ucsf.edu.
Abstract
INTRODUCTION: This study of thalamic deep brain stimulation (DBS) investigated whether a novel constant-current device improves tremor and activities of daily living (ADL) in patients with essential tremor (ET). METHODS: A prospective, controlled, multicenter study was conducted at 12 academic centers. We investigated the safety and efficacy of unilateral and bilateral constant-current DBS of the ventralis intermedius (VIM) nucleus of the thalamus in patients with essential tremor whose tremor was inadequately controlled by medications. The primary outcome measure was a rater-blinded assessment of the change in the target limb tremor score in the stimulation-on versus stimulation-off state six months following surgery. Multiple secondary outcomes were assessed at one-year follow-up, including motor, mood, and quality-of-life measures. RESULTS: 127 patients were implanted with VIM DBS. The blinded, primary outcome variable (n = 76) revealed a mean improvement of 1.25 ± 1.26 points in the target limb tremor rating scale (TRS) score in the arm contralateral to DBS (p < 0.001). Secondary outcome variables at one year revealed significant improvements (p ≤ 0.001) in quality of life, depression symptoms, and ADL scores. Forty-seven patients had a second contralateral VIM-DBS, and this group demonstrated reduction in second-sided tremor at 180 days (p < 0.001). Serious adverse events related to the surgery included infection (n = 3), intracranial hemorrhage (n = 3), and device explantation (n = 3). CONCLUSION: Unilateral and bilateral constant-current VIM DBS significantly improves upper extremity tremor, ADL, quality of life, and depression in patients with severe ET.
INTRODUCTION: This study of thalamic deep brain stimulation (DBS) investigated whether a novel constant-current device improves tremor and activities of daily living (ADL) in patients with essential tremor (ET). METHODS: A prospective, controlled, multicenter study was conducted at 12 academic centers. We investigated the safety and efficacy of unilateral and bilateral constant-current DBS of the ventralis intermedius (VIM) nucleus of the thalamus in patients with essential tremor whose tremor was inadequately controlled by medications. The primary outcome measure was a rater-blinded assessment of the change in the target limb tremor score in the stimulation-on versus stimulation-off state six months following surgery. Multiple secondary outcomes were assessed at one-year follow-up, including motor, mood, and quality-of-life measures. RESULTS: 127 patients were implanted with VIM DBS. The blinded, primary outcome variable (n = 76) revealed a mean improvement of 1.25 ± 1.26 points in the target limb tremor rating scale (TRS) score in the arm contralateral to DBS (p < 0.001). Secondary outcome variables at one year revealed significant improvements (p ≤ 0.001) in quality of life, depression symptoms, and ADL scores. Forty-seven patients had a second contralateral VIM-DBS, and this group demonstrated reduction in second-sided tremor at 180 days (p < 0.001). Serious adverse events related to the surgery included infection (n = 3), intracranial hemorrhage (n = 3), and device explantation (n = 3). CONCLUSION: Unilateral and bilateral constant-current VIM DBS significantly improves upper extremity tremor, ADL, quality of life, and depression in patients with severe ET.
Authors: Erik H Middlebrooks; Vanessa M Holanda; Ibrahim S Tuna; Hrishikesh D Deshpande; Markus Bredel; Leonardo Almeida; Harrison C Walker; Barton L Guthrie; Kelly D Foote; Michael S Okun Journal: Neuroradiology Date: 2018-01-06 Impact factor: 2.804
Authors: Sina R Potel; Sara Marceglia; Sara Meoni; Suneil K Kalia; Rubens G Cury; Elena Moro Journal: Curr Neurol Neurosci Rep Date: 2022-07-15 Impact factor: 6.030
Authors: Joshua K Wong; Christopher W Hess; Leonardo Almeida; Erik H Middlebrooks; Evangelos A Christou; Erin E Patrick; Aparna Wagle Shukla; Kelly D Foote; Michael S Okun Journal: Expert Rev Neurother Date: 2020-03-02 Impact factor: 4.618
Authors: Takashi Tsuboi; Zakia Jabarkheel; Pamela R Zeilman; Matthew J Barabas; Kelly D Foote; Michael S Okun; Aparna Wagle Shukla Journal: Neurology Date: 2020-02-11 Impact factor: 9.910
Authors: Mohammad Z Awad; Ryan J Vaden; Zachary T Irwin; Christopher L Gonzalez; Sarah Black; Arie Nakhmani; Byron C Jaeger; J Nicole Bentley; Barton L Guthrie; Harrison C Walker Journal: Ann Clin Transl Neurol Date: 2021-04-07 Impact factor: 4.511
Authors: Huiling Tan; Jean Debarros; Shenghong He; Alek Pogosyan; Tipu Z Aziz; Yongzhi Huang; Shouyan Wang; Lars Timmermann; Veerle Visser-Vandewalle; David J Pedrosa; Alexander L Green; Peter Brown Journal: Brain Stimul Date: 2019-02-21 Impact factor: 8.955
Authors: YiZi Xiao; Filippo Agnesi; Edward M Bello; Simeng Zhang; Jerrold L Vitek; Matthew D Johnson Journal: Sci Rep Date: 2018-02-01 Impact factor: 4.379