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Deep brain stimulation and spinal cord stimulation for orthostatic tremor: A systematic review

  • Author Footnotes
    1 Both authors contributed equally to this paper and are to be considered both as first authors.
    Alexandra Boogers
    Footnotes
    1 Both authors contributed equally to this paper and are to be considered both as first authors.
    Affiliations
    Department of Neurology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Research Group Experimental ORL, Department of Neurosciences, The Leuven Brain Institute, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
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  • Author Footnotes
    1 Both authors contributed equally to this paper and are to be considered both as first authors.
    Alexine Billet
    Footnotes
    1 Both authors contributed equally to this paper and are to be considered both as first authors.
    Affiliations
    Department of Neurology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
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  • Wim Vandenberghe
    Affiliations
    Department of Neurology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Laboratory for Parkinson Research, Department of Neurosciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
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  • Bart Nuttin
    Affiliations
    Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Research Group Experimental Neurosurgery and Neuroanatomy, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
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  • Tom Theys
    Affiliations
    Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Research Group Experimental Neurosurgery and Neuroanatomy, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
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  • Myles Mc Laughlin
    Affiliations
    Research Group Experimental ORL, Department of Neurosciences, The Leuven Brain Institute, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
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  • Philippe De Vloo
    Correspondence
    Corresponding author. Herestraat 49, 3000 Leuven, Belgium.
    Affiliations
    Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Research Group Experimental Neurosurgery and Neuroanatomy, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
    Search for articles by this author
  • Author Footnotes
    1 Both authors contributed equally to this paper and are to be considered both as first authors.

      Highlights

      • DBS and SCS have been performed to treat patients with orthostatic tremor.
      • Data on outcome is scarce. To get an overview, a systematic review was conducted.
      • In 32 reported cases who underwent DBS, median stance time at 1 year follow-up improved from 30 s to 240 s.
      • There is insufficient data on SCS to draw any conclusions from, on this therapy.

      Abstract

      Background

      Orthostatic tremor is a rare and debilitating movement disorder. Its first-line treatment is pharmacological. For pharmaco-refractory patients, surgical treatment options such as deep brain stimulation (DBS) and spinal cord stimulation (SCS) have been investigated recently.

      Objectives

      We conducted a systematic review of all published outcome and safety data on DBS and SCS for orthostatic tremor patients.

      Methods

      We searched Pubmed and Embase for studies describing orthostatic tremor patients treated with DBS or SCS. We collected all available outcome and safety data and our primary endpoint was the change in unsupported stance duration 1 year postoperatively (±6 months).

      Results

      We included 15 studies, reporting on 32 orthostatic tremor patients who underwent DBS, 4 patients SCS and 2 both. The ventral intermediate nucleus and the zona incerta were targeted in 25/34 and 9/34 DBS cases, respectively. The median stance time at 1 year follow-up was 240 s compared to 30 s pre-operatively (p < 0.001). Stimulation-induced side effects occurred in the majority of patients, but were often transient. Bilateral stimulation appeared more effective than unilateral and stimulation settings were comparable to thalamic DBS for essential tremor. There were insufficient data available to draw meaningful conclusions on the long-term effects of DBS. Due to insufficient data, no conclusions could be drawn on the effects of SCS on orthostatic tremor.

      Conclusion

      DBS may be effective to increase stance time in orthostatic tremor patients in the first year, but further research is necessary to evaluate the long-term effects and the role of spinal cord stimulation.

      Keywords

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      References

        • Coleman R.R.
        • et al.
        Bilateral ventral intermediate nucleus thalamic deep brain stimulation in orthostatic tremor.
        Stereotact. Funct. Neurosurg. 2016; 94: 69-74
        • Evidente V.G.H.
        • et al.
        Orthostatic tremor is responsive to bilateral thalamic deep brain stimulation: report of two cases performed asleep.
        Tremor and Other Hyperkinetic Movements. 2018; 8: 1-4
        • Gerschlager W.
        • et al.
        Natural history and syndromic associations of orthostatic tremor: a review of 41 patients.
        Mov. Disord. 2004; 19: 788-795
        • Mestre T.A.
        • et al.
        Associated movement disorders in orthostatic tremor.
        J. Neurol. Neurosurg. Psychiatry. 2012; 83: 725-729
        • Merola A.
        • et al.
        Thalamic deep brain stimulation for orthostatic tremor: a multicenter international registry.
        Mov. Disord. 2017; 32: 1240-1244
        • Hewitt A.L.
        • Klassen B.T.
        • Lee K.H.
        • Van Gompel J.J.
        • Hassan A.
        Deep brain stimulation for orthostatic tremor.
        Neurol. Clin. Pract. 2020; 10: 324-332
        • Benito-León J.
        • Domingo-Santos
        Á. Orthostatic tremor: an update on a rare entity.
        Tremor and Other Hyperkinetic Movements. 2016; 6: 411
        • Athauda D.
        • et al.
        Thalamic-caudal zona incerta deep brain stimulation for refractory orthostatic tremor: a report of 3 cases.
        Mov. Disord. Clin. Pract. 2017; 4: 105-110
        • Espay A.J.
        • et al.
        Deep brain stimulation of the ventral intermediate nucleus of the thalamus in medically refractory orthostatic tremor: preliminary observations.
        Mov. Disord. 2008; 23: 2357-2362
        • Miocinovic S.
        • Somayajula S.
        • Chitnis S.
        • Vitek J.L.
        History, applications, and mechanisms of deep brain stimulation.
        JAMA Neurol. 2013; 70: 163-171
        • Blahak C.
        • et al.
        Long-term follow-up of chronic spinal cord stimulation for medically intractable orthostatic tremor.
        J. Neurol. 2016; 263: 2224-2228
        • Moher D.
        • et al.
        Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        PLoS Med. 2009; 6
        • Dallapiazza R.F.
        • et al.
        Outcomes from stereotactic surgery for essential tremor.
        J. Neurol. Neurosurg. Psychiatry. 2019; 90: 474-482
        • Lehn A.C.
        • O'Gorman C.
        • Olson S.
        • Salari M.
        Thalamic ventral intermediate nucleus deep brain stimulation for orthostatic tremor.
        Tremor and Other Hyperkinetic Movements. 2017; 7: 1-5
        • Chiang H.-L.
        • Tai Y.-C.
        • McMaster J.
        • Fung V.S.C.
        • Mahant N.
        Primary orthostatic tremor: is deep brain stimulation better than spinal cord stimulation?.
        J. Neurol. Neurosurg. Psychiatry. 2017; 88: 804-805
        • Krauss J.K.
        • et al.
        Chronic spinal cord stimulation in medically intractable orthostatic tremor.
        J. Neurol. Neurosurg. Psychiatry. 2006; 77: 1013-1016
        • Fasano A.
        • Helmich R.C.
        Tremor habituation to deep brain stimulation: underlying mechanisms and solutions.
        Mov. Disord. 2019; 34: 1761-1773
        • Hamani C.
        • Lozano A.M.
        Hardware-related complications of deep brain stimulation: a review of the published literature.
        Stereotact. Funct. Neurosurg. 2006; 84: 248-251
        • Barbe M.T.
        • et al.
        DBS of the PSA and the VIM in essential tremor.
        Neurology. 2018; 91: e543-e550
        • Picillo M.
        • Lozano A.M.
        • Kou N.
        • Munhoz R.P.
        • Fasano A.
        Programming deep brain stimulation for tremor and dystonia: the toronto western hospital algorithms.
        Brain Stimul. 2016; 9: 438-452