Responsive Versus Continuous Deep Brain Stimulation for Speech in Essential Tremor: A Pilot Study

Overview

Journal Mov Disord

Date 2024 Jun 15

PMID 38877761

Authors

Stephanie Cernera

Sarah Long

Madison Kelberman

Karen W Hegland

Julie Hicks

May Smith-Hublou

Bryn Taylor

Yuhan Mou

Coralie de Hemptinne

Kara A Johnson

Jackson N Cagle

Kathryn Moore

Kelly D Foote

Michael S Okun

Aysegul Gunduz

Affiliations

Soon will be listed here.

Abstract

Background: Responsive deep brain stimulation (rDBS) uses physiological signals to deliver stimulation when needed. rDBS is hypothesized to reduce stimulation-induced speech effects associated with continuous DBS (cDBS) in patients with essential tremor (ET).

Objective: To determine if rDBS reduces cDBS speech-related side effects while maintaining tremor suppression.

Methods: Eight ET participants with thalamic DBS underwent unilateral rDBS. Both speech evaluations and tremor severity were assessed across three conditions (DBS OFF, cDBS ON, and rDBS ON). Speech was analyzed using intelligibility ratings. Tremor severity was scored using the Fahn-Tolosa-Marin Tremor Rating Scale (TRS).

Results: During unilateral cDBS, participants experienced reduced speech intelligibility (P = 0.025) compared to DBS OFF. rDBS was not associated with a deterioration of intelligibility. Both rDBS (P = 0.026) and cDBS (P = 0.038) improved the contralateral TRS score compared to DBS OFF.

Conclusions: rDBS maintained speech intelligibility without loss of tremor suppression. A larger prospective chronic study of rDBS in ET is justified. © 2024 International Parkinson and Movement Disorder Society.

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