Table 4.
Non-Parkinsonian Movement Disorders Clinical Studies Employing Two (or More) Targets.
| Disease | Summary of Results | Strategy | Targets | # of Subjects | Leads | IPG | Frequency (Hz), (Min, Max) | Pulse Width (μSec), (Min, Max) | Voltage (V), (Min, Max) | Current (mA), (Min, Max) | Publication Identifier | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| dystonia | BFMMS max improvement from baseline 52% (GPi only) vs 92% (VIM/VO only) vs 92% (VIM/VO+GPi) | Multi-Target | VIM / VO | GPi | 3 | Boston Scientific, Vercise Cartesia | Boston Scientific, Vercise Gevia | 89, 130 | 60 | 1.1–2 | [64] | |
| BFMDRS improvement from baseline 59% (GPi+VO) vs 55% (GPI only) vs 56% (VO only) (p<0.01) | Multi-Target | GPi | VO | 5 | Medtronic, Model 3387 | 130 | 90 | 4 | [66] | |||
| BFMDRS score 12 (GPi only) vs 0 (GPi+VIM/VO) | Multi-Target | VIM / VO | GPi | 1 | Medtronic, 3389 | Unnamed rechargable IPG | 185 | 160 | 3.5 | [62] | ||
| BFMDRS improvement from baseline 68.8% | Multi-Target | GPi | VIM | 9 | Boston Scientific; Medtornic, Activa RC | 119, 125 | 40, 210 | 1–2.6 | 1–4.7 | [63] | ||
| BFMDRS improvement from baseline 0% (GPi only) vs 0% (VIM/VO only) vs 25% (GPi+VIM/VO) | Multi-Target & Multi-Contact | GPi | VIM / VO | 1 | Medtronic, Model 3387, 3389 | Medtronic, Activa PC | 185 | 60, 90 | 4 | [67] | ||
| No additional benefit | Multi-Contact | GPi | VIM | 1 | Medtronic, Model 3387 | Medtronic, Kinetra | 150 | 210 | 3 | [297] | ||
| dystonia tremor | BFMDRS score (patient 1, patient 2) before 51,74 vs after 21,23 | Multi-Target | GPi | VIM | 2 | [68] | ||||||
| FTMTR max improvement from baseline 43.1% | Multi-Contact | VIM | cZI | 18 | Boston Scientific Vercise™ | Boston Scientific, Vercise IPG / Gevia IPG | 170, 185 | 40, 100 | 1, 4.5 | [74] | ||
| myoclonus-dystonia syndrome | UMRS improvement from baseline 54 (VIM only) vs 53.3 (GPi only) vs 41 (GPi+VIM), (GPI+VIM vs VIM only, p=0.043) | Multi-Target | GPi | VIM | 7 | Medtronic, Model 3387, 3389 | Medtronic, Kinetra | 130, 250 (VIM), 130, 180 (GPi) |
60, 210 | 0.3, 4.5 (VIM), 1.5, 4.7 (GPi) |
[69] | |
| STN+VLa induced dyskinesia, GPi+VLa induced dysarthria | Multi-Target & Multi-Contact | GPi | VLa / STN | 1 | Medtronic, Model 3387 | 135 (VO) | 120, 210 (VO) | 3.6 (VO) | [70] | |||
| UMRS myoclonus w/ action score 3 (GPi+VIM/VO) vs 9 (VIM/VO only) vs 6 (GPi only) | Multi-Target & Multi-Contact | GPi | VIM / VO | 1 | Medtronic, Model 3387 | Medtronic, Kinetra | 140 | 120 (GPi), 90 (VIM/VOA) |
2.3 (GPi), 2.1 (VIM/VOA) |
[71] | ||
| spinocerebellar ataxia type 3 (SCA3) | SARA improvement from baseline 4% (GPi only) vs 38% (DN only) vs 42% (GPi+DN) | Multi-Target | GPi | DN | 1 | PINS L301 | 60, 185 | 90, 200 | 2, 3 | [298] | ||
| essential tremor | Tremor control mean improvement 79.7% | Multi-Contact | VIM | PSA | 33 | Medtronic, Model 3387 | 125, 200 | 60, 110 | 1–4.2 | [19] | ||
| FTMTR improvement from baseline 86% | Multi-Contact | VIM | PSA | 1 | Boston Scientific | 130 | 50 | 1.5–2.6 | [20] | |||
| Report on surgical techniques | Multi-Contact | VIM | PSA | 6 | Medtronic, Model 3387 | 135 (VIM), 160 (PSA) |
60 (VIM), 90 (VIM) |
2.1 (VIM), 1.7 (PSA) |
[21] | |||
| TRS dual vs VIM only p=0.36, dual vs non-VIM lead only p=0.82 | Multi-Target | VIM | VO anterior | 2 | 130, 190 | 60, 90 (VIM), 90 (VOA) |
2.2, 3.5 (VIM), 2.8, 3.6 (VOA) |
[75] | ||||
| VIM | Raprl / PSA | 1 | 135 | 90 | 4 (VIM), 3.9 (Raprl) |
|||||||
| complex essential tremor | FTMTR max improvement from baseline 58.2% | Multi-Contact | VIM | cZI | 18 | Boston Scientific Vercise™ | Boston Scientific, Vercise IPG / Gevia IPG | 170, 185 | 40, 100 | 1, 4.5 | [74] | |
| Holmes’ tremor (HT) | TRS mean score 4 (VIM/VO only) vs 3.7 (Raprl/cZI) vs 0.7 (VIM/VO+Raprl/cZI) | Multi-Target | VIM / VO posterior | Raprl / cZI | 4 | Medtronic, Model 3387 | 135 | 210 | [299] | |||
| TRS score 16 (VIM+VO) vs 20 (VIM only) vs 19 (VO only) | Multi-Target | VIM | VO | 3 | Medtronic, Model 3387 | 135, 185 | 60, 120 | 2.9, 4.1 | [300] | |||
| multiple sclerosis tremor | TRS mean score 31 (VIM only) vs 30.88 (VO only) vs 27.61 (VIM+VO) | Multi-Target | VIM | VO | 1 | Medtronic, Model 3387 | 135 | 120 | 4 | [77] | ||
| TRS dual vs VIM only p=0.36, dual vs non-VIM lead only p=0.82 | Multi-Target | VIM | VO anterior | 1 | 130 | 60 (VIM), 90 (VOA) |
1.8 (VIM), 2.8 (VOA) |
[75] |
||||
| VIM | Raprl / PSA | 1 | 130 | 90 | 4.1 (VIM), 2.5 (Raprl) |
|||||||
| TRS reduction from baseline 29.6% (VIM+VO) vs 20% (VO only) vs 21.1% (VIM only) | Multi-Target | VIM | VO | 12 | Medtronic, Model 3387 | 135, 185 | 60, 150 (VIM), 90, 120 (VO) |
2, 4.2 (VIM), 1.5, 3.5 (VO) |
[76] | |||
| fragile X-associated tremor/ataxia syndrome (FXTAS) | Tremor resolution | Multi-Contact | VO | VIM | 1 | 130 | 2.5 | [301] | ||||
| spasmodic dysphonia (SD) | USDRS VO vs VIM+VO p<0.001, VIM vs VIM+VO p=0.20 | Multi-Contact | VO | VIM | 1 | Medtronic, Model 3387 | 185 | 60, 90 | 2,3 | [302] | ||
| neuroacanthocytosis | UHDRS score (patient 1, patient 2) GPi only 42, 36; VO only 35, 30; GPI+VO 31, 26 | Multi-Target | GPi | VO | 2 | Medtronic, Model 3387 | 160 | 90 (GPi), 60 (VO) |
3.5 (GPi), 3 (VO) |
[303] | ||
caudal Zona Incerta (cZI); Dentate Nucleus (DN); Globus Pallidus pars Interna (GPi); Posterior Subthalamic Area (PSA); Prelemniscal Radiations (Raprl); Ventralis Intermedius (VIM); Ventral Lateral Anterior (VLa); Venralis Oralis (VO)
Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS); Burke-Fahn-Marsden Movement Scale (BFMMS); Fahn-Tolosa-Marin Tremor Rating (FTMTR); Scale for the Assessment and Rating of Ataxia (SARA); Tremor Rating Scale (TRS); Unified Huntington’s Disease Rating Scale (UHDRS); Unified Myoclonus Rating Scale (UMRS); Unified Spasmodic Dysphonia Rating Scale (USDRS)