Changes in Midline Tremor and Gait Following Deep Brain Stimulation for Essential Tremor.
Ataxia
Essential tremor
Thalamus
deep brain stimulation
gait
Journal
Tremor and other hyperkinetic movements (New York, N.Y.)
ISSN: 2160-8288
Titre abrégé: Tremor Other Hyperkinet Mov (N Y)
Pays: England
ID NLM: 101569493
Informations de publication
Date de publication:
2019
2019
Historique:
received:
03
02
2019
accepted:
14
06
2019
entrez:
1
10
2019
pubmed:
1
10
2019
medline:
27
3
2020
Statut:
epublish
Résumé
Essential tremor (ET) is a common movement disorder characterized by kinetic and postural tremor in the upper extremities and frequently in the midline. Persons with ET often also exhibit gait ataxia. Previous studies have observed associations between midline tremor severity and gait ataxia in persons with ET, suggesting a common pathophysiology distinct from that of upper extremity tremor. However, a causal link between midline tremor and gait impairment has not been established. We investigated tremor and gait in 24 persons with ET before and after implantation of unilateral deep brain stimulation into the ventralis intermedius nucleus of the thalamus. Stimulation significantly improved tremor in the targeted upper extremity and midline. However, gait was unaffected at the cohort level. Furthermore, improvement in midline tremor was not significantly associated with gait improvement. These findings revealed that midline tremor and gait impairment may be dissociable in persons with ET.
Sections du résumé
Background
Essential tremor (ET) is a common movement disorder characterized by kinetic and postural tremor in the upper extremities and frequently in the midline. Persons with ET often also exhibit gait ataxia. Previous studies have observed associations between midline tremor severity and gait ataxia in persons with ET, suggesting a common pathophysiology distinct from that of upper extremity tremor. However, a causal link between midline tremor and gait impairment has not been established.
Methods
We investigated tremor and gait in 24 persons with ET before and after implantation of unilateral deep brain stimulation into the ventralis intermedius nucleus of the thalamus.
Results
Stimulation significantly improved tremor in the targeted upper extremity and midline. However, gait was unaffected at the cohort level. Furthermore, improvement in midline tremor was not significantly associated with gait improvement.
Discussion
These findings revealed that midline tremor and gait impairment may be dissociable in persons with ET.
Identifiants
pubmed: 31565538
doi: 10.7916/tohm.v0.684
pii: tre-09-684
pmc: PMC6744814
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2019 Higuchi et al.
Déclaration de conflit d'intérêts
Funding: None. Conflicts of Interest: The authors report no conflicts of interest. Ethics Statement: This study was performed in accordance with the ethical standards detailed in the Declaration of Helsinki. The authors’ institutional ethics committee has approved this study and all patients have provided written informed consent.
Références
Cerebellum. 2016 Dec;15(6):726-731
pubmed: 26563297
Gait Posture. 2012 Jun;36(2):187-93
pubmed: 22555066
Lancet. 1991 Feb 16;337(8738):403-6
pubmed: 1671433
Arch Neurol. 2006 Aug;63(8):1189-93
pubmed: 16908751
Int Rev Neurobiol. 2017;134:1373-1396
pubmed: 28805576
Clin Neuropharmacol. 1987 Aug;10(4):342-50
pubmed: 3503677
Brain. 2014 Dec;137(Pt 12):3142-8
pubmed: 25367027
Mov Disord. 1994 Mar;9(2):193-6
pubmed: 8196682
Neurosurgery. 2001 Feb;48(2):274-81; discussion 281-4
pubmed: 11220369
Mov Disord. 2009 Feb 15;24(3):386-91
pubmed: 19006189
Arch Phys Med Rehabil. 2014 Oct;95(10):1832-7
pubmed: 24769121
Mov Disord. 2016 Mar;31(3):393-401
pubmed: 26861543
Cerebellum. 2013 Feb;12(1):27-34
pubmed: 22535593
J Neurol. 2011 Sep;258(9):1643-8
pubmed: 21442464
Parkinsonism Relat Disord. 2012 Sep;18(8):1003-4
pubmed: 22795481
Neurology. 2005 Jul 12;65(1):96-101
pubmed: 16009892
J Neurol Neurosurg Psychiatry. 2019 Aug;90(8):913-919
pubmed: 30846538
Brain. 2014 Dec;137(Pt 12):3149-59
pubmed: 25273997
Mov Disord. 2018 Jan;33(1):75-87
pubmed: 29193359
Brain. 2016 Nov 1;139(11):2948-2956
pubmed: 27658421
Gait Posture. 2012 Jan;35(1):43-7
pubmed: 21930384
J Biomech. 2013 Oct 18;46(15):2682-7
pubmed: 24011360
Brain. 2010 Dec;133(Pt 12):3635-48
pubmed: 20926368
Mov Disord. 2010 Aug 15;25(11):1633-8
pubmed: 20629168
Mov Disord. 2014 Sep;29(10):1329-30
pubmed: 25042039
Gait Posture. 2013 Sep;38(4):956-61
pubmed: 23726428
J Neurol Neurosurg Psychiatry. 2005 May;76(5):684-90
pubmed: 15834027
Parkinsonism Relat Disord. 2013 Sep;19(9):789-94
pubmed: 23742969
Tremor Other Hyperkinet Mov (N Y). 2014 Aug 14;4:259
pubmed: 25157323
Parkinsonism Relat Disord. 2019 Mar;60:126-132
pubmed: 30220556
Brain. 2001 Nov;124(Pt 11):2278-86
pubmed: 11673328
Mov Disord. 2007 Apr 30;22(6):833-8
pubmed: 17343274
Gait Posture. 2011 May;34(1):65-70
pubmed: 21478017
Parkinsonism Relat Disord. 2011 Jul;17(6):406-9
pubmed: 21600832