TY  - JOUR
A1  - Reitz, Sarah
A1  - Luger, Sebastian
A1  - Lapa, Sriramya
A1  - Eibach, Michael Bernd
A1  - Filmann, Natalie
A1  - Seifert, Volker
A1  - Weise, Lutz
A1  - Klein, Johannes C.
A1  - Kang, Jun-Suk
A1  - Baudrexel, Simon
A1  - Quick-Weller, Johanna
T1  - Comparing programming sessions of vim-DBS
T2  - Frontiers in neurology
N2  - Background: Essential Tremor (ET) is a progressive neurological disorder characterized by postural and kinetic tremor most commonly affecting the hands and arms. Medically intractable ET can be treated by deep brain stimulation (DBS) of the ventral intermediate nucleus of thalamus (VIM). We investigated whether the location of the effective contact (most tremor suppression with at least side effects) in VIM-DBS for ET changes over time, indicating a distinct mechanism of loss of efficacy that goes beyond progression of tremor severity, or a mere reduction of DBS efficacy.
Methods: We performed programming sessions in 10 patients who underwent bilateral vim-DBS surgery between 2009 and 2017 at our department. In addition to the intraoperative (T1) and first clinical programming session (T2) a third programming session (T3) was performed to assess the effect- and side effect threshold (minimum voltage at which a tremor suppression or side effects occurred). Additionally, we compared the choice of the effective contact between T1 and T2 which might be affected by a surgical induced “brain shift.”
Discussion: Over a time span of about 4 years VIM-DBS in ET showed continuous efficacy in tremor suppression during stim-ON compared to stim-OFF. Compared to immediate postoperative programming sessions in ET-patients with DBS, long-term evaluationshowednorelevantchangeinthechoiceofcontactwithrespecttosideeffects andefficacy.InthemajorityofthecasestheactivecontactatT2didnotcorrespondtothe most effective intraoperative stimulation site T1, which might be explained by a brain-shift due to cerebral spinal fluid loss after neurosurgical procedure.
KW  - DBS
KW  - essential tremor
KW  - ventralis intermedius nucleus
KW  - VIM
KW  - brain shift
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/55912
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-559121
SN  - 1664-2295
N1  - © 2020 Reitz, Luger, Lapa, Eibach, Filmann, Seifert, Weise, Klein, Kang, Baudrexel and Quick-Weller. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
VL  - 11
IS  - art. 987
SP  - 1
EP  - 6
PB  - Frontiers
CY  - Lausanne
ER  -