Oregon Health and Science University
This will be a single center (OHSU) proof of concept trial to demonstrate that directional deep brain stimulation (DBS) creates a larger therapeutic window for the treatment of essential tremor (ET), effectively treats ET, and minimizes effects on speech, gait and balance compared to nondirectional DBS.
Specific Aims: 1. To compare the therapeutic window (TW) of directional versus nondirectional deep brain stimulation for treatment of tremor. Hypothesis: directional DBS will result in a wider TW than nondirectional DBS. 2. To compare the effects of directional versus nondirectional DBS on speech Hypothesis: Objective and subjective speech impairment will occur to a greater extent in nondirectional DBS versus directional DBS optimized for tremor control. 3. To compare the effects of directional versus nondirectional DBS on balance and gait Hypothesis: Objective and subjective balance and…
Inclusion Criteria: * A tremor syndrome of bilateral upper limb action tremor with at least 3 years' duration Exclusion Criteria: * Patients who have decided not to receive DBS for control of their medication-refractory essential tremor. * Patients with secondary tremor (ie not Essential Tremor), such as side effects from medications, secondary to another identified neurologic disease (eg multiple sclerosis, -----Parkinson's disease, dystonia). * Prior history of deep brain stimulation. * Prior history of thalamotomy. * A history or signs of dystonia, ataxia or parkinsonism. * Task specific…
Deep brain stimulation of the thalamus, in a directional and nondirectional manner
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