Objective: To analyze the efficacy of VIM DBS in relieving head tremors in patients with Essential Tremors at Cleveland Clinic.

Background: Deep Brain Stimulation (DBS), particularly targeting the ventral intermediate nucleus (VIM), has demonstrated significant efficacy in mitigating tremors affecting the arms and hands in patients with essential tremor (ET). However, the effectiveness of DBS in alleviating head tremors within this population remains relatively unexplored, along with the associated influencing factors. Herein, we present preliminary findings from a single-center experience.

Method: We conducted a retrospective chart review of patients diagnosed with ET who underwent unilateral or bilateral VIM DBS procedures at the Center for Neurological Restoration (CNR) within the Cleveland Clinic between January 2020 and December 2023. Patients without a confirmed diagnosis of ET or those presenting with concurrent diagnoses of ET and Parkinson’s disease (PD) were excluded from the study. Head tremor severity was assessed using the Fahn-Tolosa-Marin (FTM) Tremor Rating Scale preoperatively and at the first visit available following 3 months postoperatively, with concurrent recording of stimulation parameters. A positive response was defined as an improvement of at least 1 point in sub-item of the FTM scale. Statistical analyses, including Student’s t-tests and chi-square tests, were employed to evaluate group differences.

Results: Among the 150 patients who underwent VIM DBS, 48 patients with ET met the inclusion criteria for our study by having the two time-point scales and DBS parameters available. The mean age was 68.0±7.5 years, with a disease duration of 24.0±15.0 years. The average preoperative resting head tremor severity was 1.2±0.7, while postural head tremor severity was 1.11±0.77. The average time for postoperative FTM visit was 4.3±5.1 months. Eighty-five percent of patients exhibited a positive response to treatment. For responders, the average amplitude and frequency were 1.9±0.7 mA and 138.8±13.5 Hz, respectively, compared to 1.7±0.7 mA and 135.4±16.4 Hz for non-responders (p-value =0.602, and 0.474, respectively).

Conclusion: Our preliminary findings suggest that VIM DBS shows promising efficacy in managing head tremors in patients with ET. However, a more extensive review is ongoing to comprehensively analyze factors associated with treatment response and to validate these results.

Graphical Abstract

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effectiveness-of-vim-dbs-for-head-tremor-in-essential-tremor-patients-a-single-center-experience/