Deep brain stimulation for essential tremor and Parkinson's disease
Institute for Clinical Systems Improvement
Record ID 32003000545
English
Authors' objectives:
This review aims to assess the available evidence on the effectiveness of deep brain stimulation for essential tremor (ET) and Parkinson's disease (PD).
Authors' recommendations:
With respect to deep brain stimulation (DBS) for essential tremor (ET) and Parkinsons disease (PD), the ICSI Technology Assessment Committee finds the following:
DBS offers a reversible, adjustable, and lower risk option to ablative surgery for the control of ET and for the control of tremor and motor disorders in patients with PD. Suitability for DBS must be established on a case-by-case basis following an examination by a movement disorders specialist. DBS involves risks but most of the observed adverse effects have been transient. Higher complication rates are likely with bilateral DBS, especially bilateral DBS of the STN and GPi. In patients with PD, it has not been determined how to identify the most appropriate location for DBS. Long-term follow-up data are limited.
DBS of the Vim is effective in reducing tremor associated with ET and PD. For ET patients, functional ability is also improved; for PD patients, motor performance is enhanced. For bilateral tremor, DBS should also be bilateral as the effects are observed primarily on the contralateral side. (Conclusion Grade II based on Class D evidence)
In PD, DBS of the STN is effective in improving motor function and ADL scores and reducing tremor. Bilateral stimulation is superior to unilateral stimulation. (Conclusion Grade II based on Class D evidence)
In PD, stimulation of the GPi can lead to improved clinical and functional outcomes (including motor function, ADL score, and other symptoms of PD) although the results have been less consistent than with Vim or STN stimulation. (Conclusion Grade II based on Class D evidence)
Authors' methods:
Review
Details
Project Status:
Completed
URL for project:
http://www.icsi.org/index.asp
Year Published:
2000
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Brain
- Electric Stimulation Therapy
- Essential Tremor
- Parkinson Disease
Contact
Organisation Name:
Institute for Clinical Systems Improvement
Contact Address:
8009 34th Avenue South, Suite 1200, Bloomington, MN, USA. Tel: +1 952 814 7060; Fax: +1 952 858 9675
Contact Name:
icsi.info@icsi.org
Contact Email:
icsi.info@icsi.org
Copyright:
Institute for Clinical Systems Improvement (ICSI)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.