Bilateral subthalamic nucleus deep brain stimulation in a patient with cervical dystonia and essential tremor
Chou KL, Hurtig HI, Jaggi JL, Baltuch GH. (2005) Bilateral subthalamic nucleus deep brain stimulation in a patient with cervical dystonia and essential tremor Movement Disorders, 2005 Mar;20(3):377-80
This article is interesting in that it discusses how DBS-STN may be beneficial for disorders (e.g. cervical dystonia [CD] or essential tremor [ET]) other than PD, that have similar motor symptoms (e.g. tremor and dystonia). Research on CD and ET is limited but generally looks promising. These authors discuss a case of a patient with CD and ET that underwent DBS-STN. The patient began showing movement symptoms (head tremor and right head tilt) at the age of 39. She underwent medical therapies for twelve years and was then evaluated at a movement disorders clinic. After further evaluation she was also diagnosed with ET. She underwent additional medical treatment for two more years before deciding on DBS-STN. She developed an infection in the right DBS lead approximately 3 months after the surgery but was without complications after reimplantation (2 months later). One month after reimplantation she had full suppression of her tremor, neck pain, and her head posture had almost returned to normal. After 6 months, her positive results remained and her only adverse event was mild dysarthria that ceased after additional adjustment of her stimulators. The authors cited studies (Leigh et al, 1983; Lopiano et al, 2003) that have shown an approximate 80% reduction in action tremor (tremor specifically seen when people are moving a body part) in patients with both PD and ET that underwent stimulation of the STN. Many studies addressing DBS in patients with dystonia have focused on the GPi and others that have focused on STN have shown mixed results regarding the efficacy of DBS-STN for dystonia patients. This case study showed efficacy for a patient with CD and ET, suggesting that further research is needed to evaluate the efficacy of DBS-STN for other movement disorders as well as to understand the pathophysiology (looking at how the damage is done in the body) of these conditions.