PMID- 32802034
OWN - NLM
STAT- MEDLINE
DCOM- 20210623
LR  - 20210623
IS  - 1687-5443 (Electronic)
IS  - 2090-5904 (Print)
IS  - 1687-5443 (Linking)
VI  - 2020
DP  - 2020
TI  - Outcomes and Adverse Effects of Deep Brain Stimulation on the Ventral 
      Intermediate Nucleus in Patients with Essential Tremor.
PG  - 2486065
LID - 10.1155/2020/2486065 [doi]
LID - 2486065
AB  - OBJECTIVE: This study was aimed at identifying the potential outcome predictors, 
      comparing the efficacy in patients with different tremor characteristics, and 
      summarizing the adverse effect rates (AERs) of deep brain stimulation on the 
      ventral intermediate nucleus (VIM-DBS) for essential tremor (ET). METHODS: An 
      extensive search of articles published to date in 2019 was conducted, and two 
      main aspects were analyzed. Improvement was calculated as a percentage of change 
      in any objective tremor rating scale (TRS) and analyzed by subgroup analyses of 
      patients' tremor characteristics, laterality, and stimulation parameters. 
      Furthermore, the AERs were analyzed as follows: the adverse effects (AEs) were 
      classified as stimulation-related, surgical-related, or device-related effects. A 
      simple regression analysis was used to identify the potential prognostic factors, 
      and a two-sample mean-comparison test was used to verify the statistical 
      significance of the subgroup analyses. RESULTS: Forty-six articles involving 1714 
      patients were included in the meta-analysis. The pooled improvement in any 
      objective TRS score was 61.3% (95% CI: 0.564-0.660) at the mean follow-up visit 
      (20.0 +/- 17.3 months). The midline and extremity symptoms showed consistent 
      improvement (P = 0.440), and the results of the comparison of postural and 
      kinetic tremor were the same (P = 0.219). In addition, the improvement in rest 
      tremor was similar to that in action tremor (OR = 2.759, P = 0.120). In the 
      simple regression analysis, the preoperative Fahn-Tolosa-Marin Tremor Rating 
      Scale (FTM-TRS) scores and follow-up time were negatively correlated with the 
      percentage change in any objective TRS score (P < 0.05). The most common adverse 
      event was dysarthria (10.5%), which is a stimulation-related AE (23.6%), while 
      the rates of the surgical-related and device-related AEs were 6.4% and 11.5%, 
      respectively. CONCLUSION: VIM-DBS is an efficient and safe surgical method in ET, 
      and the efficacy was not affected by the body distribution of tremor, age at 
      surgery, and disease duration. Lower preoperative FTM-TRS scores likely indicate 
      greater improvement, and the effect of VIM-DBS declines over time.
CI  - Copyright (c) 2020 Guohui Lu et al.
FAU - Lu, Guohui
AU  - Lu G
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, Jiangxi, China.
FAU - Luo, Linfeng
AU  - Luo L
AD  - The First Clinical Medical College of Nanchang University, Nanchang, Jiangxi, 
      China.
FAU - Liu, Maolin
AU  - Liu M
AD  - The First Clinical Medical College of Nanchang University, Nanchang, Jiangxi, 
      China.
FAU - Zheng, Zijian
AU  - Zheng Z
AD  - The First Clinical Medical College of Nanchang University, Nanchang, Jiangxi, 
      China.
FAU - Zhang, Bohan
AU  - Zhang B
AD  - The First Clinical Medical College of Nanchang University, Nanchang, Jiangxi, 
      China.
FAU - Chen, Xiaosi
AU  - Chen X
AD  - The First Clinical Medical College of Nanchang University, Nanchang, Jiangxi, 
      China.
FAU - Hua, Xing
AU  - Hua X
AD  - The First Clinical Medical College of Nanchang University, Nanchang, Jiangxi, 
      China.
FAU - Fan, Houyou
AU  - Fan H
AD  - The First Clinical Medical College of Nanchang University, Nanchang, Jiangxi, 
      China.
FAU - Mo, Guoheng
AU  - Mo G
AD  - Queen Mary College of Nanchang University, Nanchang, Jiangxi, China.
FAU - Duan, Jian
AU  - Duan J
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, Jiangxi, China.
FAU - Li, MeiHua
AU  - Li M
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, Jiangxi, China.
FAU - Hong, Tao
AU  - Hong T
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, Jiangxi, China.
FAU - Zhou, Dongwei
AU  - Zhou D
AUID- ORCID: 0000-0003-2216-2337
AD  - Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, 
      Nanchang, Jiangxi, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20200801
PL  - United States
TA  - Neural Plast
JT  - Neural plasticity
JID - 100883417
SB  - IM
MH  - *Deep Brain Stimulation/adverse effects
MH  - Essential Tremor/physiopathology/*therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Thalamus/*physiopathology
MH  - Treatment Outcome
PMC - PMC7416257
COIS- The authors report no conflicts of interest concerning the materials or methods 
      used in this study or the findings specified in this paper.
EDAT- 2020/08/18 06:00
MHDA- 2021/06/24 06:00
PMCR- 2020/08/01
CRDT- 2020/08/18 06:00
PHST- 2020/03/28 00:00 [received]
PHST- 2020/06/24 00:00 [revised]
PHST- 2020/07/03 00:00 [accepted]
PHST- 2020/08/18 06:00 [entrez]
PHST- 2020/08/18 06:00 [pubmed]
PHST- 2021/06/24 06:00 [medline]
PHST- 2020/08/01 00:00 [pmc-release]
AID - 10.1155/2020/2486065 [doi]
PST - epublish
SO  - Neural Plast. 2020 Aug 1;2020:2486065. doi: 10.1155/2020/2486065. eCollection 
      2020.