Table 2.
Case reports and series of thalamic and subthalamic deep brain stimulation (DBS) in patients with dystonic tremor..
| Author | Etiology | Target | Outcome | Follow-up |
|---|---|---|---|---|
| Minguez-Castellanos et al. (1999) [51] | One patient with PWT | Contralateral VIM | Clinical improvement in TRS of 4 points | 1 year |
| Kitagawa et al. (2000) [52] | One patient with DT | Contralateral VIM | Tremor markedly improved. Speech was improved as well | N/A |
| Racette et al. (2001) [53] | One patient with PWT | Contralateral VIM | Marked improvement in TRS from 18/144 to 1/144 (94% improvement) | N/A |
| Vercueil et al. (2001) [54] | Four patients with dystonic arm tremor | Contralateral VLp | Improvement in tremor with VLP DBS despite no benefit in dystonia | 12 months |
| Deuschl et al. (2002) [55] | One patient with DT | Bilateral VIM | Tremor improvement (no specific scale or percentage reported) | N/A |
| Krause et al. (2004) [56] | One patient with severe dystonic cervical tremor in a series of patients with primary dystonia | Bilateral Gpi | 55.6% mean improvement in BFMDS motor score in cohort, no improvement in dystonic cervical tremor | 36 months |
| Chou et al. (2005) [57] | Severe cervical tremor | Bilateral STN | TWSTRS improved from 14 to 3 points | Six months |
| Fukaya et al. (2007) [58] | 5 patients with PWT | Contralateral VIM (4) and Gpi (1) | 91% mean improvement in BMFDR handwriting scale | 24 months |
| Schadt et al. (2007) [59] | One patient with head dystonic tremor | VIM + Gpi | Patient reported dramatic improvement in quality of life | N/A |
| Plaha et al. (2008) [35] | DT in setting of generalized dystonia | Caudal Zi | 65% and 70% improvement in BFM and TRS, respectively | 12 months |
| Blomstedt et al. (2009) [60] | Two patients with DT and one patient with PWT | Contralateral PSA | Patients with DT had resolution of tremor and 80% benefit in PWT | 12 months |
| Jeong et al. (2009) [61] | One patient with postanoxic generalized dystonia with asymmetric DT | Bilateral PSA | There was 80.5% and 89.5% improvement on the movement scale and the disability scale of the BFMDRS, respectively, and 64.9% improvement in TRS | 6 months |
| Kuncel et al. (2009) [62] | One patient with DT in myoclonus-dystonia | Bilateral VIM | Marked tremor improvement using CGI scale and >50% improvement in TRS | 9 months |
| Woehrle et al. (2009) [63] | Two patients with prominent DT | Contralateral VIM DBS | 53.6% and 59.8% improvements in motor | 11–21 months |
| Torres et al. (2010) [64] | One patient with dystonic neck tremor and CD, right torticollis | Right Gpi | 75% reduction in dystonic tremor and 60% in cervical tremor (TWSTRS) | 3 months |
| Morishita et al. (2010) [65] | One patient with DT and generalized dystonia, one patient isolated DT, one patient with DT and segmental dystonia | One patient with unilateral and bilateral VIM and one patient with bilateral VIM + Gpi | 50% improvement in TRS in two patients and 25% in one patient | 4 years in two patients and 6 months in one patient |
| Lyons et al. (2011) [66] | One patient with PWT | Contralateral VIM | No scales reported. Complete resolution of writing tremor | Six months |
| Hedera et al. (2013) [67] | Six patients generalized dystonia; three patients hemidystonia, one segmental dystonia | Four patients received VIM; six patients bilateral Gpi; two patients combined VIM + Gpi | Average benefit in WHIGET scores was 84.7% with VIM vs. 39.8% with Gpi | N/A |
BMFDRS, Burke–Marsden–Fahn’s Dystonia Rating Scale; CD, cervical dystonia; DT, dystonic tremor; FTM, Fahn–Tolosa–Marin Tremor Rating Scale; GPi, globus pallidus internus; PWT, primary writing tremor; STN, subthalamic nucleus; VIM, ventral intermedius nucleus; VLp, ventrolateral posterior thalamus; WHIGET, Washington Heights-Inwood Genetic Study of Essential Tremor; Zi, Zona incerta.