期刊
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
卷 85, 期 5, 页码 567-572出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/jnnp-2013-304943
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资金
- Medtronic
- Merz Pharmaceuticals
- Acadia
- Siena
- Neurosearch Sweden
- Phytopharm
- Schering-Plough
- Avid Radiopharmaceutical
- Allergan, Inc
- Allon Therapeutics
- Biotie
- Ceregene, Inc
- Chelsea Therapeutics
- Diana Helis Henry Medical Research Foundation
- EMD Serono
- Huntington's Disease Society of America
- Huntington Study Group
- Impax Pharmaceuticals
- Ipsen Limited
- Lundbeck Inc
- Michael J Fox Foundation for Parkinson Research
- National Institutes of Health
- National Parkinson Foundation
- Neurogen
- St. Jude Medical
- Teva Pharmaceutical Industries Ltd
- University of Rochester
- Parkinson Study Group
Background Deep brain stimulation (DBS) has proven to be a safe and effective therapy for refractory essential tremor, but information regarding long-term outcomes is lacking. Objectives We aimed to assess the long-term safety and efficacy of DBS in patients with essential tremor. Methods Patients treated with DBS for essential tremor for at least 8 years were evaluated in the 'on' and 'off' state using the Fahn-Tolosa-Marin tremor rating scale, and their medical records were reviewed to assess complications related to this therapy. Results We studied 13 patients (7 men): median age at evaluation 79 years (range 47-88), median age at electrode implantation 68 years (range 37-78) and mean time since electrode implantation 132.54 +/-15.3 months (range 114-164). The difference between the 'off' and 'on' state on the motor items of the tremor rating scale was 41.9% (58.62 vs 34.08, p<0.001) in the non-blinded and 37.2% (56.07 vs 35.23, p<0.001) in the blinded rating. DBS provided a functional improvement of 31.7% in the 'on' state (15.07 vs 22.07, p<0.001). A total non-blinded improvement in the tremor rating scale of 39% was observed in the 'on' state (49.15 vs 80.69, p<0.001). Dysarthria and disequilibrium were common in patients with bilateral stimulation. A DBS-related surgery (electrode revision or internal pulse generator exchange) was necessary on average every 47.9 months to continue with the DBS therapy. Conclusions Thalamic DBS is a safe and effective therapy in patients with essential tremor followed for up to 13 years.
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