Novel DBS Approach Shows Promise for Long-Term Essential Tremor Control

A novel deep brain stimulation (DBS) treatment specifically targeting the dentato-rubro-thalamic tract (DRTt) was associated with statistically significant improvements in tremor control for patients with refractory essential tremor (ET) according to study results presented at the 2024 International Congress of Parkinson’s Disease and Movement Disorders. Previous DBS treatments for patients with drug-resistant ET have typically targeted the ventral intermediate nucleus of the thalamus, which is theoretically thought to engage neural networks such as the DRTt. 

Researchers used diffusion tensor imaging (dTi) to target the DRTt in 12 patients—average age, 63.7 years (range, 20 to 77); average ET duration, 18.3 years (range, 1 to 50) at baseline—who were implanted with one of two primary cell (PC) impulse generators produced by Medtronic (Minneapolis, MN): Activa PC (n=11) and Percept PC (n=1). Before implantation, baseline composite tremor scores for distal hand tremors were assessed on The Essential Tremor Rating Assessment Scale (TETRAS).

At the 2-year follow-up, participants demonstrated a statistically significant (P<.001) reduction in composite tremor scores: from 10.8 points (SD±3.9) to 4.5 points (SD±4.1). The average stimulation parameters were low to moderate throughout the study: frequency, 130 Hz (range, 130 to 190); pulse width, 60 μs (range, 60 to 120); amplitude, 2.3–2.4 V (range, 1.8 to 4.2). 

The improvement in distal hand tremor showed the potential efficacy of DRTt DBS for the long-term control of refractory ET.