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Longitudinal follow-up of dual-lead thalamic deep brain stimulation for patients with treatment refractory multiple sclerosis tremor

B. Patel, R. Barmore, A. Elkouzi, P. Zeilman, X. Bai, L. Almeida, K. Foote, M. Okun (Gainesville, FL, USA)

Meeting: 2018 International Congress

Abstract Number: 503

Keywords: Cerebellar tremors(see Tremor), Deep brain stimulation (DBS), Multiple sclerosis(MS)

Session Information

Date: Saturday, October 6, 2018

Session Title: Surgical Therapy: Other Movement Disorders

Session Time: 1:45pm-3:15pm

Location: Hall 3FG

Objective: To report long-term outcome measurements of tremor control in patients with medically refractory multiple sclerosis tremor and dual lead thalamic deep brain stimulation.

Background: Multiple Sclerosis (MS) tremor is typically pharmacoresistant and disabling. Studies of treatment outcomes with stereotactic lesioning or single-lead deep brain stimulation (DBS) have been variable. Dual-lead thalamic DBS targeting the ventralis intermedius (VIM) and ventralis oralis (VO) has been shown to be a safe and effective therapy. Currently there is limited data on long-term outcomes of dual-lead thalamic DBS for tremor management. We report long-term outcomes in a cohort of patients with medically refractory MS tremor treated with dual-lead thalamic DBS.

Methods: Retrospective review of 19 patients with medically refractory tremor who underwent dual-lead thalamic DBS from 2007-2015. In this study 15 patients were included who were evaluated using the Tolosa-Fahn-Marin Tremor Rating Scale (TRS) before surgery and on-stimulation at 1, 3, and 5 years postoperatively.

Results: Median total TRS scores improved from baseline during a five-year follow-up (p=0.026). Median TRS motor scores were reduced from baseline during this period (p=0.044). No statistically significant differences were found in TRS activities of daily living (ADL) scores postoperatively compared to pre-surgical baseline (p=0.212).

Conclusions: Dual-lead thalamic DBS is potentially an effective treatment for the long-term improvement of severe, medication refractory tremor in MS. Although there is an improvement in motor scores, the disability questionnaire components remained unchanged from baseline.

References: Oliveria SF, Rodriguez RL, Bowers D, et al. Safety and efficacy of dual-lead thalamic deep brain stimulation for patients with treatment-refractory multiple sclerosis tremor: a single-centre, randomised, single-blind, pilot trial. Lancet Neurol. 2017;16(9):691-700. doi:10.1016/S1474-4422(17)30166-7.

To cite this abstract in AMA style:

B. Patel, R. Barmore, A. Elkouzi, P. Zeilman, X. Bai, L. Almeida, K. Foote, M. Okun. Longitudinal follow-up of dual-lead thalamic deep brain stimulation for patients with treatment refractory multiple sclerosis tremor [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/longitudinal-follow-up-of-dual-lead-thalamic-deep-brain-stimulation-for-patients-with-treatment-refractory-multiple-sclerosis-tremor/. Accessed July 16, 2025.
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