Helmholtz Gemeinschaft


Overnight unilateral withdrawal of thalamic deep brain stimulation to identify reversibility of gait disturbances

PDF (Original Article) - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
[img] Other (Supplementary Data)

Item Type:Article
Title:Overnight unilateral withdrawal of thalamic deep brain stimulation to identify reversibility of gait disturbances
Creators Name:Kroneberg, D. and Al-Fatly, B. and Schmitz-Hübsch, T. and Gandor, F. and Gruber, D. and Ebersbach, G. and Horn, A. and Kühn, A.A.
Abstract:BACKGROUND: Gait disturbances are frequent side effects related to chronic thalamic deep brain stimulation (DBS) that may persist beyond cessation of stimulation. OBJECTIVE: We investigate the temporal dynamics and clinical effects of an overnight unilateral withdrawal of DBS on gait disturbances. METHODS: 10 essential tremor (ET) patients with gait disturbances following thalamic DBS underwent clinical and kinematic gait assessment ON DBS, after instant and after an overnight unilateral withdrawal of DBS of the hemisphere corresponding to the non-dominant hand. The effect of stimulation withdrawal on gait performance was quantitatively assessed using clinical rating and inertial sensors and compared to gait kinematics from 10 additional patients with ET but without subjective gait impairment. DBS leads were reconstructed and active contacts were visualized in relation to surrounding axonal pathways and nuclei. RESULTS: Patients with gait deterioration following DBS exhibited greater excursion of sagittal trunk movements and greater variability of stride length and shank range of motion compared to ET patients without DBS and without subjective gait impairment. Overnight but not instant withdrawal of unilateral DBS resulted in significant reduction of SARA axial subscore and stride length variability, while tremor control of the dominant hand was preserved. Cerebellothalamic, striatopallidofugal and corticospinal fibers were in direct vicinity of transiently deactivated contacts. CONCLUSION: Non-dominant unilateral cessation of VIM DBS may serve as a therapeutic option as well as a diagnostic tool to detect stimulation-induced gait disturbances that is applicable in ambulatory settings due to preserved functionality of the dominant hand.
Keywords:Deep Brain Stimulation, Essential Tremor, Gait Ataxia, Sensor Based Motion Analysis, Neuromodulation
Source:Experimental Neurology
Page Range:114135
Date:September 2022
Official Publication:https://doi.org/10.1016/j.expneurol.2022.114135
PubMed:View item in PubMed

Repository Staff Only: item control page


Downloads per month over past year

Open Access
MDC Library