학술논문

Benefits and Risks of a Staged‐Bilateral VIM Versus Unilateral VIM DBS for Essential Tremor
Document Type
article
Source
Movement Disorders Clinical Practice. 9(6)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Neurosciences
Rehabilitation
Assistive Technology
Prevention
Clinical Research
Neurodegenerative
Bioengineering
essential tremor
thalamic deep brain stimulation
outcomes
VIM DBS
Clinical sciences
Language
Abstract
BackgroundDespite over 30 years of clinical experience, high-quality studies on the efficacy of bilateral versus unilateral deep brain stimulation (DBS) of the ventral intermediate (VIM) nucleus of the thalamus for medically refractory essential tremor (ET) remain limited.ObjectivesTo compare benefits and risks of bilateral versus unilateral VIM DBS using the largest ET DBS clinical trial dataset available to date.MethodsParticipants from the US St. Jude/Abbott pivotal ET DBS trial who underwent staged-bilateral VIM implantation constituted the primary cohort in this sub-analysis. Their assessments "on" DBS at six months after second-side VIM DBS implantation were compared to the assessments six months after unilateral implantation. Two control cohorts of participants with unilateral implantation only were also used for between-group comparisons.ResultsThe primary cohort consisted of n = 38 ET patients (22M/16F; age of 65.3 ± 9.5 years). The second side VIM-DBS resulted in a 29.6% additional improvement in the total motor CRST score (P