Journal of Neurology

, Volume 258, Issue 3, pp 434–439

Deep brain stimulation in the nucleus ventralis intermedius in patients with essential tremor: habituation of tremor suppression

  • Michael T. Barbe
  • Lena Liebhart
  • Matthias Runge
  • K. Amande M. Pauls
  • Lars Wojtecki
  • Alfons Schnitzler
  • Niels Allert
  • Gereon R. Fink
  • Volker Sturm
  • Mohammad Maarouf
  • Lars Timmermann
Original Communication

DOI: 10.1007/s00415-010-5773-3

Cite this article as:
Barbe, M.T., Liebhart, L., Runge, M. et al. J Neurol (2011) 258: 434. doi:10.1007/s00415-010-5773-3

Abstract

In patients with essential tremor (ET) already treated with chronic deep brain stimulation (DBS) of the nucleus ventralis intermedius (VIM) we investigated whether optimization of stimulation parameters could improve clinical tremor suppression, and whether this putative effect could be sustained over time. Twenty-three ET patients with VIM-DBS participated in the prospective study. All electrode contacts were tested systematically and stimulation parameters were optimized over the course of 2 days. Clinical tremor rating scale (TRS) was videotaped before, directly after the optimization and at a 10 weeks follow-up and evaluated blindly and independently by two clinicians. For stimulation effect optimization we increased the number of active contacts whereas the total charge applied to the tissue was kept constant. TRS hemi-body scores decreased significantly after optimization. At the 10 weeks follow-up, however, the improvement had faded and was no longer significant. The activities of daily living (ADL) remained significantly improved. Systematic optimization of VIM-DBS parameters in ET patients leads to a short term improvement which habituates over time. Our results provide further evidence for a tolerance effect in chronic VIM stimulation thereby suggesting that frequently alternating stimulation protocols should be tested in future studies of ET patients treated with VIM-DBS.

Keywords

Essential tremor Deep brain stimulation Nucleus ventralis intermedius Habituation Tolerance 

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Michael T. Barbe
    • 1
    • 2
  • Lena Liebhart
    • 1
  • Matthias Runge
    • 3
  • K. Amande M. Pauls
    • 1
  • Lars Wojtecki
    • 4
    • 5
  • Alfons Schnitzler
    • 4
    • 5
  • Niels Allert
    • 6
  • Gereon R. Fink
    • 1
    • 2
  • Volker Sturm
    • 3
  • Mohammad Maarouf
    • 3
  • Lars Timmermann
    • 1
  1. 1.Department of NeurologyUniversity Hospital CologneCologneGermany
  2. 2.Cognitive Neurology SectionInstitute of Neuroscience and Medicine (INM-3), Research Centre JülichJülichGermany
  3. 3.Department of Stereotaxy and Functional NeurosurgeryUniversity Hospital CologneCologneGermany
  4. 4.Institute of Clinical Neuroscience and Medical PsychologyHeinrich-Heine UniversityDüsseldorfGermany
  5. 5.Department of NeurologyHeinrich-Heine UniversityDüsseldorfGermany
  6. 6.Neurological Rehabilitation Center GodeshoeheBonnGermany

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