This title appears in the Scientific Report : 2011 

Deep brain stimulation in the Nucleus ventralis intermedius in patients with essential tremor: Habituation of tremor suppression
Barbe, M.T.
Liebhart, M. / Runge, M. / Pauls, K.A.M. / Wojtecki, L. / Schnitzler, A. / Allert, N. / Fink, G.R. / Sturm, V. / Maarouf, M. / Timmermann, L.
Kognitive Neurowissenschaften; INM-3
Journal of Neurology, 258 (2011) S. 434 - 439
[Darmstadt] Steinkopf 2011
434 - 439
20927533
10.1007/s00415-010-5773-3
Journal Article
(Dys-)function and Plasticity
Funktion und Dysfunktion des Nervensystems
Journal of Neurology 258
J
Please use the identifier: http://dx.doi.org/10.1007/s00415-010-5773-3 in citations.
In patients with essential tremor (ET) already treated with chronic deep brain stimulation (DBS) of the nucleus ventralis intermedius (VIM) we investigated whether optimization of stimulation parameters could improve clinical tremor suppression, and whether this putative effect could be sustained over time. Twenty-three ET patients with VIM-DBS participated in the prospective study. All electrode contacts were tested systematically and stimulation parameters were optimized over the course of 2 days. Clinical tremor rating scale (TRS) was videotaped before, directly after the optimization and at a 10 weeks follow-up and evaluated blindly and independently by two clinicians. For stimulation effect optimization we increased the number of active contacts whereas the total charge applied to the tissue was kept constant. TRS hemi-body scores decreased significantly after optimization. At the 10 weeks follow-up, however, the improvement had faded and was no longer significant. The activities of daily living (ADL) remained significantly improved. Systematic optimization of VIM-DBS parameters in ET patients leads to a short term improvement which habituates over time. Our results provide further evidence for a tolerance effect in chronic VIM stimulation thereby suggesting that frequently alternating stimulation protocols should be tested in future studies of ET patients treated with VIM-DBS.