Deep Brain Stimulation for Essential Tremor and Other Tremor Syndromes: A Narrative Review of Current Targets and Clinical Outcomes

Abstract

Tremor is a prevalent symptom associated with multiple conditions, including Essential Tremor (ET), Parkinson’s disease (PD), multiple sclerosis (MS), stroke, and trauma. The surgical management of tremor evolved from stereotactic lesions to deep-brain stimulation (DBS), which allowed safe and reversible interference with specific neural networks. This paper reviews the current literature on DBS for tremor, starting with a detailed discussion of current tremor targets (Vim, Raprl, caudal Zi, Vo and STN) and continuing with a discussion of results obtained when performing DBS in the various aforementioned tremor syndromes. Future directions for DBS research are then briefly discussed.

Review of Medicine Utilization for Parkinson's Disease Management: The Bulgarian Perspective

“…Limited knowledge about the mechanisms of neurodegeneration in PD and the heterogeneity of the pathology are the main challenges in the field of neurology. New diagnostic methods, gene therapy 36 ,non-dopaminergic strategy for neuroprotection, xanthine derivatives research 37,38 , approaches for antagonism of adenosine A2A receptors, monoamine oxidase type-B inhibition (MAO-B) 39,40 , and deep-brain stimulation 41 are promising tools for achieving better clinical results in disease management.…”

Converging on a Neuromodulation Target for Tremor

“…Severe action and intention tremor is one of the most common and disabling movement disorders. Often with unknown cause in essential tremor, tremor can also be a disabling symptom of Parkinson's disease, multiple sclerosis, and many other disorders 1,2 . Medication is often insufficient, motivating invasive treatments.…”

“…with unknown cause in essential tremor, tremor can also be a disabling symptom of Parkinson's disease, multiple sclerosis, and many other disorders. 1,2 Medication is often insufficient, motivating invasive treatments. Lesion-based therapies for tremor date back to the mid-1900s, evolving into stereotactic radio-frequency lesioning in the 1950s 3 and permanently implanted deep brain stimulation (DBS) electrodes in 1989.…”

Connecting tremors – a circuits perspective

“…From microelectrode and local field potential recordings, tremor-specific activity is known to be present in the vim [22–24]. Deep brain stimulation (DBS) targeting the vim and its afferent fibers (the dentato-rubro-thalamic tract, DRRT) is successful in alleviating tremor with different underlying etiologies [25]. When stimulating the vim in humans (nine ET patients, two PD patients), periodic excitatory responses are observed when stimulating at 5 Hz and 10 Hz [26 ▪▪ ].…”