Putzke J D, Wharen R E, Obwegeser A A, Wszolek Z K, Lucas J A, Turk M F, Uitti R J
Department of Neurology, Mayo Clinic, Jacksonville, FL 32224 , USA.
Can J Neurol Sci. 2004 Aug;31(3):333-42. doi: 10.1017/s0317167100003413.
Determine the efficacy of thalamic deep brain stimulation (DBS) for tremor control among individuals with essential tremor (ET).
A clinical series of 52 consecutive individuals undergoing placement of a DBS system for treatment of ET completed an unblinded battery of subjective and objective measures at postoperative intervals of one, three, and 12 months, and annually thereafter up to three years. The assessment battery included measures of tremor and activities of daily living.
Both subjective and objective measures showed that stimulation was associated with significant improvement at nearly every postoperative interval as compared to pre-operative and stimulation 'off' ratings of activities of daily living functioning, midline tremor, contralateral upper extremity tremor, and contralateral lower extremity tremor. Ipsilateral tremor showed some improvement with stimulation, but only within the first three months. Trend analysis showed stable tremor control. Stimulation settings remained largely unchanged after the first three months. Dysarthria was more common among those with bilateral stimulation. A range of missing data estimation methods were performed, and subsequent analyses corroborated the main findings of the study.
Thalamic DBS is generally a well-tolerated and effective treatment for ET. Methodological and analytical recommendations are provided for the evaluation of long-term outcome.
确定丘脑深部脑刺激（DBS）对特发性震颤（ET）患者震颤控制的疗效。
一项临床系列研究，52例连续接受DBS系统植入治疗ET的患者在术后1个月、3个月和12个月以及此后每年直至3年的时间间隔完成了一组未设盲的主观和客观测量。评估项目包括震颤测量和日常生活活动测量。
主观和客观测量均显示，与术前以及刺激“关闭”状态下的日常生活功能、中线震颤、对侧上肢震颤和对侧下肢震颤评分相比，几乎在每个术后时间间隔，刺激均与显著改善相关。同侧震颤在刺激后有一定改善，但仅在最初三个月内。趋势分析显示震颤控制稳定。最初三个月后刺激设置基本保持不变。构音障碍在双侧刺激患者中更常见。进行了一系列缺失数据估计方法，后续分析证实了该研究的主要发现。
丘脑DBS通常是一种耐受性良好且有效的ET治疗方法。为长期疗效评估提供了方法学和分析建议。
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