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Abstract Details

Therapeutic Outcomes of Directional Deep Brain Stimulation in Essential Tremor Patients
Movement Disorders
P7 - Poster Session 7 (8:00 AM-9:00 AM)
5-007

Analyzing directional deep brain stimulation (DBS) outcomes in Essential Tremor (ET) patients using the Abbott Infinity and Boston Scientific Vercise Systems.
Stimulation of the Ventralis Intermedius nucleus of the thalamus (VIM) effectively suppresses tremors in patients with ET. Data on the long-lasting benefits of directional current delivery remains limited.
Tremor was evaluated in 9 ET patients implanted with directional DBS leads using the Fahn-Tolosa-Marin Tremor Scale (FTM). One patient was subsequently diagnosed with parkinsonism. In our sample 7 patients were implanted bilaterally and 2 unilaterally, 7 implanted with Abbott Infinity and 2 with the Boston Scientific Vercise system. FTM assessments were obtained preoperatively and 7 to 16 months following device activation. 

On average patients exhibited tremors for 23.3 ±17.9 years. Mean age at surgery was 67.2 ±11.0 years. Preoperatively FTM scores ranged from 36 to 88 points with a mean of 51.3 ±15.9, while 11.6 ±2.9 months post device activation FTM scores ON stimulation ranged 7 to 31 points and averaged 15.9±8.2. FTM scores ON stimulation at postoperative follow-up decreased by 66% when compared with FTM scores at baseline. Medication reduction or discontinuation was observed in 71% of patients who were prescribed tremor suppressing medications at baseline. Segmented DBS contacts were used in 15 of the 16 directional leads.
Tremor control using directional DBS leads in ET patients is evident by reduction in FTM scores approximately 1 year following DBS activation, especially in the setting of medication reduction. Future analysis of clinical outcomes in a larger cohort and investigation of directional DBS lead parameters is necessary to thoroughly understand and optimize directional current stimulation.
Authors/Disclosures
Alina Shub, PA (University of South Florida)
PRESENTER 		The institution of Ms. Shub has received research support from Abbott and Boston Scientific .
No disclosure on file
Theresa A. Zesiewicz, MD (University of South Florida) Dr. Zesiewicz has received personal compensation for serving as an employee of Medscape. Dr. Zesiewicz has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lexeo. Dr. Zesiewicz has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Steminent. Dr. Zesiewicz has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Larimar. Dr. Zesiewicz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Zesiewicz has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Zesiewicz has received intellectual property interests from a discovery or technology relating to health care. Dr. Zesiewicz has received intellectual property interests from a discovery or technology relating to health care. Dr. Zesiewicz has received intellectual property interests from a discovery or technology relating to health care.
No disclosure on file
Yarema Bezchlibnyk Yarema Bezchlibnyk has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Yarema Bezchlibnyk has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for PMT Inc. Yarema Bezchlibnyk has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbott. Yarema Bezchlibnyk has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Boston Scientific. Yarema Bezchlibnyk has received research support from Medtronic.