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首页> 外文期刊>Journal of neurology >Deep brain stimulation in the nucleus ventralis intermedius in patients with essential tremor: habituation of tremor suppression.
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Deep brain stimulation in the nucleus ventralis intermedius in patients with essential tremor: habituation of tremor suppression.

机译：原发性震颤患者的中间腹内侧深脑刺激：抑制震颤的习惯。

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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.
机译：在已经用中间腹侧神经的慢性深部脑刺激（DBS）治疗过的原发性震颤（ET）患者中，我们调查了刺激参数的优化是否可以改善临床震颤抑制，以及这种推定的效果能否随着时间持续。 23例VIM-DBS的ET患者参加了这项前瞻性研究。系统地测试了所有电极的接触，并在2天的过程中优化了刺激参数。在优化前，优化后以及10周的随访中录制了临床震颤评定量表（TRS），并由两名临床医生进行了盲目和独立的评估。为了优化刺激效果，我们增加了活动触点的数量，而施加到组织的总电荷保持恒定。优化后，TRS半体得分显着下降。但是，在10周的随访中，这种改善已经消失，不再显着。日常生活活动（ADL）仍显着改善。 ET患者中VIM-DBS参数的系统优化导致短期改善，并随着时间的推移逐渐适应。我们的结果为慢性VIM刺激的耐受性作用提供了进一步的证据，从而表明在未来对VIM-DBS治疗的ET患者的研究中应测试频繁交替的刺激方案。

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