J. Crayton Pruitt Department of Biomedical Engineering, Gainesville, Florida, USA.
Department of Speech, Language, and Hearing Sciences, Norman Fixel Institute for Neurological Diseases, Gainesville, Florida, USA.
Mov Disord. 2024 Sep;39(9):1619-1623. doi: 10.1002/mds.29865. Epub 2024 Jun 15.
Responsive deep brain stimulation (rDBS) uses physiological signals to deliver stimulation when needed. rDBS is hypothesized to reduce stimulation-induced speech effects associated with continuous DBS (cDBS) in patients with essential tremor (ET).
To determine if rDBS reduces cDBS speech-related side effects while maintaining tremor suppression.
Eight ET participants with thalamic DBS underwent unilateral rDBS. Both speech evaluations and tremor severity were assessed across three conditions (DBS OFF, cDBS ON, and rDBS ON). Speech was analyzed using intelligibility ratings. Tremor severity was scored using the Fahn-Tolosa-Marin Tremor Rating Scale (TRS).
During unilateral cDBS, participants experienced reduced speech intelligibility (P = 0.025) compared to DBS OFF. rDBS was not associated with a deterioration of intelligibility. Both rDBS (P = 0.026) and cDBS (P = 0.038) improved the contralateral TRS score compared to DBS OFF.
rDBS maintained speech intelligibility without loss of tremor suppression. A larger prospective chronic study of rDBS in ET is justified. © 2024 International Parkinson and Movement Disorder Society.
响应式脑深部刺激（rDBS）使用生理信号在需要时提供刺激。rDBS 被假设可以减少与震颤相关的副作用，而不会降低连续脑深部刺激（cDBS）对特发性震颤（ET）患者的震颤抑制作用。
确定 rDBS 是否可以在维持震颤抑制的同时减少 cDBS 相关的言语副作用。
8 名丘脑 DBS 的 ET 参与者接受了单侧 rDBS。在三种条件下（DBS 关闭、cDBS 开启和 rDBS 开启）评估了言语评估和震颤严重程度。使用可理解性评分分析言语。使用 Fahn-Tolosa-Marin 震颤评定量表（TRS）对震颤严重程度进行评分。
在单侧 cDBS 期间，与 DBS 关闭相比，参与者的言语可理解性降低（P = 0.025）。rDBS 与可理解性恶化无关。rDBS（P = 0.026）和 cDBS（P = 0.038）与 DBS 关闭相比，均改善了对侧 TRS 评分。
rDBS 维持了言语的可理解性，而不会降低震颤抑制。有必要对 ET 中的 rDBS 进行更大规模的前瞻性慢性研究。
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