Featured Research

from universities, journals, and other organizations

Most patients stop drugs for essential tremor after deep brain stimulation surgery

Date:
April 7, 2011
Source:
University of South Florida (USF Health)
Summary:
Deep brain stimulation, a surgical procedure to suppress faulty nerve signals, allowed most patients to stop the medications used to treat disabling essential tremors within one year following the surgery, researchers report.

University of South Florida neurologist Dr. Theresa Zesiewicz and research assistant Andrew Resnick look at the image of a brain with a deep brain stimulation device lead implanted.
Credit: Copyright University of South Florida

Deep brain stimulation, a surgical procedure to suppress faulty nerve signals, allowed 77 percent of patients to stop the medications used to treat their essential tremors within one year following the surgery, University of South Florida researchers report.

"It's a significant finding demonstrating that patients see a lot of symptom improvement with this treatment option," said Andrew Resnick, a research assistant in the USF Health Department of Neurology. Resnick will present results of the limited retrospective study April 12, 2011, at the annual meeting of the American Academy of Neurology in Honolulu, Hawaii.

Essential tremor, which affects the hands, head and voice, is three times more prevalent than Parkinson's disease. The largely hereditary neurological condition can cause uncontrollable shaking that interferes with normal daily activities such as eating, drinking and getting dressed. Tremors can begin in early adulthood and become more severe as a person grows older.

While medications (primidone, propranolol and/or topiramate) help alleviate essential tremors in some patients, over time many patients discontinue the drugs because their effectiveness wanes or the side effects become intolerable, said USF Health neurologist Theresa Zesiewicz, MD, who was the lead author in developing the AAN's first guidelines for treatment of essential tremor. "Essentially, they just give up trying to treat essential tremor."

The USF study reviewed the charts of 31 patients who underwent unilateral deep brain stimulation (DBS) surgery for essential tremor from 2000 to 2010. The therapy uses an implanted device similar to a pacemaker to stimulate a targeted region of the brain with electrical impulses, blocking or correcting abnormal nerve signals that cause the tremors.

At the time of surgery, 20 of the 31 patients had been diagnosed with essential tremor for 10 or more years and 11 had been diagnosed for less than 10 years.

The researchers found that all 13 patients still taking anti-tremor medications at the time of DBS surgery gained effective control of their tremors following the procedure. In fact, symptom improvement was so good that 10 patients in this group (77 percent) stopped the anti-tremor medications within one year of surgery. The remaining three (23 percent) continued to take propranolol, an antihypertensive as well as an anti-tremor drug, only because they still needed it to control blood pressure.

Eighteen of the 31 patients (54 percent) had discontinued anti-tremor medications a year or more before the DBS surgery -- 10 because the medications stopped working and eight because of adverse side effects such as nausea, headaches and other flu-like symptoms, drops in blood pressure, cognitive impairment or depression. Most patients in this group had long-standing essential tremor (10 or more years). All these patients also benefitted from the DBS surgery, though some experienced longer symptom improvement than others.

USF Health neurosurgeon Dr. Donald Smith, a pioneer in DBS surgery, has performed more than 200 procedures since the FDA approved the anti-tremor treatment in 1997.

By the time patients reach the point of contemplating surgery, the tremors are usually very debilitating, said Dr. Smith, surgical co-director of the Movement Disorders Clinic in the USF Department of Neurosurgery.

"People may not be able to write, or comb their hair; they can't use tools, can't sew or knit. They have difficult feeding themselves and drinking, so they're often embarrassed to go out to eat." Dr Smith said. "It a rewarding procedure to perform, because most patients come in with high levels of disability and can be turned around quickly. It's a home-run surgery."

A limitation of the USF study was that only unilateral DBS, which treats one side of the brain affecting tremors in the dominant hand, was examined. Bilateral DBS for tremor in both hands is associated with more side effects, Dr. Zesiewicz said, but patients are often satisfied when they regain control in the dominant hand.

Future research should include larger, long-term studies investigating how long the tremor control effects of DBS last, the researchers conclude. For instance, will patients who have undergone the procedure need medication again 10 to 20 years after the surgery, or can physicians alter the intensity of electrical impulses delivered by the DBS device so that the procedure's benefits are sustained?

In addition to Resnick, Dr. Smith and Dr. Zesiewicz, USF Health's Teresita Malapira, Dr. Fernando Vale, Kelly Sullivan (neuroepidemiologist) and Amber Miller, and the University of Florida's Dr. Michael Okun conducted the study.


Story Source:

The above story is based on materials provided by University of South Florida (USF Health). Note: Materials may be edited for content and length.


Cite This Page:

University of South Florida (USF Health). "Most patients stop drugs for essential tremor after deep brain stimulation surgery." ScienceDaily. ScienceDaily, 7 April 2011. <www.sciencedaily.com/releases/2011/04/110407101411.htm>.
University of South Florida (USF Health). (2011, April 7). Most patients stop drugs for essential tremor after deep brain stimulation surgery. ScienceDaily. Retrieved April 17, 2014 from www.sciencedaily.com/releases/2011/04/110407101411.htm
University of South Florida (USF Health). "Most patients stop drugs for essential tremor after deep brain stimulation surgery." ScienceDaily. www.sciencedaily.com/releases/2011/04/110407101411.htm (accessed April 17, 2014).

Share This



More Health & Medicine News

Thursday, April 17, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Could Even Casual Marijuana Use Alter Your Brain?

Could Even Casual Marijuana Use Alter Your Brain?

Newsy (Apr. 16, 2014) A new study conducted by researchers at Northwestern and Harvard suggests even casual marijuana use can alter your brain. Video provided by Newsy
Powered by NewsLook.com
Thousands Of Vials Of SARS Virus Go Missing

Thousands Of Vials Of SARS Virus Go Missing

Newsy (Apr. 16, 2014) A research institute in Paris somehow misplaced more than 2,000 vials of the deadly SARS virus. Video provided by Newsy
Powered by NewsLook.com
Formerly Conjoined Twins Released From Dallas Hospital

Formerly Conjoined Twins Released From Dallas Hospital

Newsy (Apr. 16, 2014) Conjoined twins Emmett and Owen Ezell were separated by doctors in August. Now, nearly nine months later, they're being released from the hospital. Video provided by Newsy
Powered by NewsLook.com
Ebola Outbreak Now Linked To 121 Deaths

Ebola Outbreak Now Linked To 121 Deaths

Newsy (Apr. 15, 2014) The ebola virus outbreak in West Africa is now linked to 121 deaths. Health officials fear the virus will continue to spread in urban areas. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins