Nicholas J Brandmeir1,2, Ann Murray3,2, Cletus Cheyuo1,2, Christopher Ferari4, Ali R Rezai1,2. 1. Department of Neurosurgery, West Virginia University, Morgantown, West Virginia. 2. Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia. 3. Department of Neurology, West Virginia University, Morgantown, West Virginia. 4. West Virginia School of Medicine, West Virginia University, Morgantown, West Virginia.
Abstract
OBJECTIVES: To examine the effect of deep brain stimulation (DBS) on multiple sclerosis (MS)-tremor, as measured by a normalized scale of tremor severity, with a meta-analysis of the published literature. METHODS: Medline and EBSCO Host (January, 1998 to June, 2018) were systematically reviewed with librarian guidance, using the keywords "Deep brain stimulation" and "multiple sclerosis." Bibliographies and experts in the field were also consulted to identify missed articles. All therapeutic studies on DBS for MS-tremor, reported in the English language, within the study period were included. Papers that reported outcomes without a measure of central tendency and/or distribution were excluded. The papers were read in their entirety and graded for risk of bias according to the American Academy of Neurology (AAN) standards. To maximize statistical power, papers using different stimulation targets were grouped together. Outcomes were reported with the Fahn-Tolosa-Marin scale (FTM), the Bain-Finchley scale (CRS) and 3- and 4-point tremor severity scales and normalized with a Hedges g. RESULTS: The search produced 13 studies suitable for meta-analysis. The random-effects meta-analysis showed that DBS improved the Hedges standardized mean tremor score by 2.86 (95%CI 2.03-3.70, p < .00001). Heterogeneity was high, with an I2 of 84%, suggesting that random effects model is more appropriate. Adverse event rates varied from 8% to 50%. CONCLUSIONS: This meta-analysis provides level III evidence that DBS may improve MS-related tremor as measured by standardized tremor severity scales.
OBJECTIVES: To examine the effect of deep brain stimulation (DBS) on multiple sclerosis (MS)-tremor, as measured by a normalized scale of tremor severity, with a meta-analysis of the published literature. METHODS: Medline and EBSCO Host (January, 1998 to June, 2018) were systematically reviewed with librarian guidance, using the keywords "Deep brain stimulation" and "multiple sclerosis." Bibliographies and experts in the field were also consulted to identify missed articles. All therapeutic studies on DBS for MS-tremor, reported in the English language, within the study period were included. Papers that reported outcomes without a measure of central tendency and/or distribution were excluded. The papers were read in their entirety and graded for risk of bias according to the American Academy of Neurology (AAN) standards. To maximize statistical power, papers using different stimulation targets were grouped together. Outcomes were reported with the Fahn-Tolosa-Marin scale (FTM), the Bain-Finchley scale (CRS) and 3- and 4-point tremor severity scales and normalized with a Hedges g. RESULTS: The search produced 13 studies suitable for meta-analysis. The random-effects meta-analysis showed that DBS improved the Hedges standardized mean tremor score by 2.86 (95%CI 2.03-3.70, p < .00001). Heterogeneity was high, with an I2 of 84%, suggesting that random effects model is more appropriate. Adverse event rates varied from 8% to 50%. CONCLUSIONS: This meta-analysis provides level III evidence that DBS may improve MS-related tremor as measured by standardized tremor severity scales.
Authors: W M M Schüpbach; N Chastan; M L Welter; J L Houeto; V Mesnage; A M Bonnet; V Czernecki; D Maltête; A Hartmann; L Mallet; B Pidoux; D Dormont; S Navarro; P Cornu; A Mallet; Y Agid Journal: J Neurol Neurosurg Psychiatry Date: 2005-12 Impact factor: 10.154
Authors: Jan Herzog; Wolfgang Hamel; Roland Wenzelburger; Monika Pötter; Marcus O Pinsker; Jan Bartussek; Andre Morsnowski; Frank Steigerwald; Günther Deuschl; Jens Volkmann Journal: Brain Date: 2007-04-17 Impact factor: 13.501
Authors: Sean J Pittock; Robyn L McClelland; William T Mayr; Moses Rodriguez; Joseph Y Matsumoto Journal: Mov Disord Date: 2004-12 Impact factor: 10.338
Authors: Seth F Oliveria; Ramon L Rodriguez; Dawn Bowers; Daniel Kantor; Justin D Hilliard; Erin H Monari; Bonnie M Scott; Michael S Okun; Kelly D Foote Journal: Lancet Neurol Date: 2017-06-20 Impact factor: 44.182
Authors: Joshua K Wong; Bhavana Patel; Erik H Middlebrooks; Justin D Hilliard; Kelly D Foote; Michael S Okun; Leonardo Almeida Journal: Brain Commun Date: 2022-03-15