Journal Article

FZJ-2013-05881

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Individualized current-shaping reduces DBS-induced dysarthria in patients with essential tremor

Barbe, M. (Corresponding author)FZJ* ; Dembek, T. ; Becker, J. ; Raethjen, J. ; Hartinger, M. ; Meister, I. ; Runge, M. ; Maarouf, M. ; Fink, G. R.FZJ* ; Timmermann, L.

2014
Lippincott Williams & Wilkins Hagerstown, Md.

This record in other databases:      

Please use a persistent id in citations: http://hdl.handle.net/2128/5638  doi:10.1212/WNL.0000000000000127

Abstract: Objective: To investigate in patients with essential tremor (ET) treated with thalamic/subthalamic deep brain stimulation (DBS) whether stimulation-induced dysarthria (SID) can be diminished by individualized current-shaping with interleaving stimulation (cs-ILS) while maintaining tremor suppression (TS).Methods: Of 26 patients screened, 10 reported SID and were invited for testing. TS was assessed by the Tremor Rating Scale and kinematic analysis of postural and action tremor. SID was assessed by phonetic and logopedic means. Additionally, patients rated their dysarthria on a visual analog scale.Results: In 6 of the 10 patients with ET, DBS-ON (relative to DBS-OFF) led to SID while tremor was successfully reduced. When comparing individualized cs-ILS with a non–current-shaped interleaving stimulation (ILS) in these patients, there was no difference in TS while 4 of the 6 patients showed subjective improvement of speech during cs-ILS. Phonetic analysis (ILS vs cs-ILS) revealed that during cs-ILS there was a reduction of voicing during the production of voiceless stop consonants and also a trend toward an improvement in oral diadochokinetic rate, reflecting less dysarthria. Logopedic rating showed a trend toward deterioration in the diadochokinesis task when comparing ON with OFF but no difference between ILS and cs-ILS.Conclusion: This is a proof-of-principle evaluation of current-shaping in patients with ET treated with thalamic/subthalamic DBS and experiencing SID. Data suggest a benefit on SID from individual shaping of current spread while TS is preserved.Classification of evidence: This study provides Class IV evidence that in patients with ET treated with DBS with SID, individualized cs-ILS reduces dysarthria while maintaining tremor control.

---

Contributing Institute(s):

1. Kognitive Neurowissenschaften (INM-3)

Research Program(s):

1. 333 - Pathophysiological Mechanisms of Neurological and Psychiatric Diseases (POF2-333) (POF2-333)
2. 89572 - (Dys-)function and Plasticity (POF2-89572) (POF2-89572)

Appears in the scientific report 2014

---

Database coverage:
; ; ; BIOSIS Previews ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; JCR ; NCBI Molecular Biology Database ; SCOPUS ; Science Citation Index ; Science Citation Index Expanded ; Thomson Reuters Master Journal List ; Web of Science Core Collection

---