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J Neurol Neurosurg Psychiatry 1999 Mar;66(3):289-96

Multicentre European study of thalamic stimulation in parkinsonian and
essential tremor.

Limousin P, Speelman JD, Gielen F, Janssens M
Department of Clinical and Biological Neurosciences, Joseph Fourier
University, Grenoble, France.

OBJECTIVES: Thalamic stimulation has been proposed to treat disabling
tremor. The aims of this multicentre study were to evaluate the efficacy and
the morbidity of thalamic stimulation in a large number of patients with
parkinsonian or essential tremor. METHODS: One hundred and eleven patients
were included in the study and 110 were implanted either unilaterally or
bilaterally. Patients were evaluated with clinical scales, before and up to
12 months after surgery. RESULTS: Upper and lower limb tremor scores were
reduced in both groups. Eighty five per cent of the electrodes satisfied the
arbitrary criteria of two point reduction in rest tremor reduction in the
parkinsonian tremor group and 89% for postural tremor reduction in the
essential tremor group. In the parkinsonian tremor group, limb akinesia and
limb rigidity scores were moderately but significantly reduced. Axial scores
were unchanged. In the essential tremor group, head tremor was significantly
reduced only at 3 months and voice tremor was non-significantly reduced.
Activities of daily living were improved in both groups. Changes in
medication were moderate. Adverse effects related to the surgery were mild
and reversible. CONCLUSIONS: Thalamic stimulation was shown to be an
effective and relatively safe treatment for disabling tremor. This procedure
initially applied in a very limited number of centres has been successfully
used in 13 participating centres.

Publication Types:

Clinical trial
Multicenter study
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PMID: 10084526, UI: 99182017