Deep brain stimulation in uncommon tremor disorders: indications, targets, and programming.

摘要: In uncommon tremor disorders, clinical efficacy and optimal anatomical targets for deep brain stimulation (DBS) remain inadequately studied insufficiently quantified. We performed a systematic review of PubMed.gov ClinicalTrials.gov. Relevant articles were identified using the following keywords: “tremor”, “Holmes tremor”, “orthostatic “multiple sclerosis”, sclerosis “neuropathy”, “neuropathic “fragile X-associated tremor/ataxia syndrome”, X.” total 263 cases treated with DBS disorders. Of these, 44 had Holmes (HT), 18 orthostatic (OT), 177 multiple (MS)-associated tremor, 14 neuropathy-associated 10 fragile tremor/ataxia syndrome (FXTAS). resulted in favorable, albeit partial, improvements HT receiving Vim-DBS alone or combination additional targets. A sustained improvement was reported OT bilateral Vim-DBS, while two unilateral demonstrated only transient effect. MS-associated responded to dual-target Vim-/VO-DBS, but inability account progression disability impeded assessment its long-term efficacy. Neuropathy-associated substantially improved Vim-DBS. FXTAS patients, effective improving equivocal results observed those ataxia. select may represent an therapeutic strategy although level evidence is currently incipient form based on single limited case series. An international registry is, therefore, warranted clarify selection criteria, results, surgical