Objective tremor registration during DBS surgery for Essential Tremor

Spiridon Papapetropoulos, Bruno V. Gallo, Alexandra Guevara, Carlos Singer, Georgia Mitsi, Charalampos Lyssikatos, Jonathan R. Jagid

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Essential Tremor (ET) is characterized by a 4-12-Hz postural and kinetic tremor, most commonly affecting the upper limbs. Deep brain stimulation (DBS) of the thalamus (Vim) has been found to be highly effective in severe/refractory forms of ET. Intra-operative assessment of tremor is performed using clinical methods based on patient and physician perception of tremor intensity. We present for the first time the case of a patient whose tremor was objectively monitored/quantified pre- and intra-operatively using device-based tremor registration to supplement clinical measures. We present the case of a 76-year-old right-handed woman that received unilateral (left-sided) DBS of the ventrointermediate (Vim) nucleus of thalamus (Vim) for medically refractory ET. Tremor was monitored with an accelerometer-based Tremor Pen®, which is part of a simple portable device (CATSYS 2000 System®, Danish Product Development Ltd., DK, www.catsys.dk). The patient was asked to perform tasks for tremor evaluation before and during thalamic DBS. Tremor quantification revealed a significant improvement (34.7-fold) in the contralateral (right) limb following macro-stimulation. No significant improvement was registered in the ipsilateral (non-operated) side. Simple electronic tremor registration methods during DBS of the Vim nucleus of the thalamus may supplement the existing methodology that is solely based on subjective measures derived from clinical observations.

Original languageEnglish (US)
Pages (from-to)376-379
Number of pages4
JournalClinical Neurology and Neurosurgery
Volume111
Issue number4
DOIs
StatePublished - May 1 2009

Keywords

  • CATSYS
  • Essential Tremor
  • Intra-operative monitoring
  • Tremor

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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