Neurophysiologic assessment of ET patients treated by Vim DBS
Research type
Research Study
Full title
Assessment of cerebellar ataxia related to ventral intermediate median nucleus deep brain stimulation in essential tremor: a multimodal neurophysiologic study
IRAS ID
274481
Contact name
Patricia Limousin
Contact email
Sponsor organisation
University College London
Clinicaltrials.gov Identifier
Z6364106/2020/07/89, UCL data-protection number
Duration of Study in the UK
0 years, 2 months, 28 days
Research summary
Essential tremor is a chronic and progressive neurological disease characterized by upper limb tremor. Most of the time the disease worsens over the disease course, affecting patients’ work abilities and in the most severe cases activities of daily living such as eating or dressing. For the most disabled patients, Deep brain stimulation (DBS) of the thalamic ventral intermediate median nucleus (Vim), a procedure consisting of the implantation of an electrode in a structure of the brain involved in tremor genesis, is the gold standard treatment. While this therapy is most of the time highly effective in alleviating the tremor, some subjects may exhibit gait impairment or upper limb coordination troubles years after the surgery, which are thought to be due to the involuntary stimulation of efferent cerebellar fiber tract. Unfortunately, this DBS induced side effect cannot be systematically avoided and may limit the possibilities of settings adaptation required to control the tremor. Surprisingly, while it could be a valuable therapeutic option for these patients suffering from DBS induced balance troubles, little is known about the effect of varying the rate of stimulation on the gait disorders associated with essential tremor and Vim DBS. The aim of or study is consequently to assess the effect of different frequency of stimulation on tremor, gait and balance disorders in patients uni or bilaterally stimulated in the Vim for a severe and medically intractable essential tremor. We will include patients followed at the National Hospital for Neurology and Neurosurgery (University College London Hospital). To better characterize the different symptoms, we will use ataxia and tremor rating scale together with 3D gait motion analysis and computerized spiral test analysis. We assume that our findings may lead to a better understanding of Vim-DBS associated gait disorders in essential tremor.
REC name
South Central - Berkshire Research Ethics Committee
REC reference
20/SC/0338
Date of REC Opinion
24 Sep 2020
REC opinion
Favourable Opinion