Frontiers in Human Neuroscience (Feb 2024)

Management of essential tremor deep brain stimulation-induced side effects

  • Alfonso Enrique Martinez-Nunez,
  • Alfonso Enrique Martinez-Nunez,
  • Filipe P. Sarmento,
  • Vyshak Chandra,
  • Christopher William Hess,
  • Christopher William Hess,
  • Justin David Hilliard,
  • Justin David Hilliard,
  • Michael S. Okun,
  • Michael S. Okun,
  • Joshua K. Wong,
  • Joshua K. Wong

DOI
https://doi.org/10.3389/fnhum.2024.1353150
Journal volume & issue
Vol. 18

Abstract

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Deep brain stimulation (DBS) is an effective surgical therapy for carefully selected patients with medication refractory essential tremor (ET). The most popular anatomical targets for ET DBS are the ventral intermedius nucleus (VIM) of the thalamus, the caudal zona incerta (cZI) and the posterior subthalamic area (PSA). Despite extensive knowledge in DBS programming for tremor suppression, it is not uncommon to experience stimulation induced side effects related to DBS therapy. Dysarthria, dysphagia, ataxia, and gait impairment are common stimulation induced side effects from modulation of brain tissue that surround the target of interest. In this review, we explore current evidence about the etiology of stimulation induced side effects in ET DBS and provide several evidence-based strategies to troubleshoot, reprogram and retain tremor suppression.

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