TY  - JOUR
AU  - Barbe, Michael
AU  - Reker, Paul
AU  - Hamacher, Stefanie
AU  - Franklin, Jeremy
AU  - Kraus, Daria
AU  - Dembek, Till A.
AU  - Becker, Johannes
AU  - Steffen, Julia K.
AU  - Allert, Niels
AU  - Wirths, Jochen
AU  - Dafsari, Haidar S.
AU  - Voges, Jürgen
AU  - Fink, Gereon R.
AU  - Visser-Vandewalle, Veerle
AU  - Timmermann, Lars
TI  - DBS of the PSA and the VIM in essential tremor
JO  - Neurology
VL  - 91
IS  - 6
SN  - 1526-632X
CY  - Philadelphia, Pa.
PB  - Wolters Kluwer
M1  - FZJ-2018-04049
SP  - page 247
PY  - 2018
AB  - Objective To evaluate deep brain stimulation (DBS) of the posterior subthalamic area (PSA) in essential tremor (ET) and compare it to the ventral intermediate nucleus of the thalamus (VIM) in terms of stimulation efficacy, efficiency, and side effects.Methods DBS leads were implanted such that contacts were placed in the VIM, on the intercommissural line, and in the PSA. Thirteen patients with ET entered a randomized, double-blind crossover phase and completed a 1-year follow-up.Results PSA-DBS significantly reduced tremor severity and improved quality of life. There were no relevant differences in quality and frequency of stimulation side effects between VIM and PSA, with a tendency toward greater tremor improvement with PSA stimulation. Clinical benefit was achieved at significantly lower stimulation amplitudes in the PSA. The majority of patients remained with PSA-DBS after 1 year.Conclusion In accordance with previous retrospective investigations, our prospective data suggest that PSA-DBS is at least equally effective as but possibly more efficient than VIM-DBS.Classification of evidence This study provides Class I evidence that for patients with essential tremor, PSA-DBS is not significantly different from VIM-DBS in suppressing tremor, but clinical benefit from PSA-DBS is attained at lower stimulation amplitudes.
LB  - PUB:(DE-HGF)16
C6  - pmid:29970404
UR  - <Go to ISI:>//WOS:000442266600006
DO  - DOI:10.1212/WNL.0000000000005956
UR  - https://juser.fz-juelich.de/record/849954
ER  -