{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:51:49Z","timestamp":1774659109238,"version":"3.50.1"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007582","name":"Alberta Health Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007582","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","award":["#RGPIN\/04126-2017"],"award-info":[{"award-number":["#RGPIN\/04126-2017"]}],"id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> Essential tremor (ET) is a tremor syndrome characterized by bilateral, upper limb action tremor. Essential tremor-plus (ET-plus) describes ET patients with additional neurologic signs. It is unknown whether there is a difference in response to treatment with ventralis intermedius nucleus deep brain stimulation (VIM DBS) in patients with ET and ET-plus. Due to potential variability in underlying etiology in ET-plus, there is a concern that ET-plus patients may have worse outcomes. The aim of this study was to identify whether patients with ET-plus have worse tremor outcomes after VIM DBS than patients with ET.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> This is a retrospective chart and video review evaluating VIM DBS outcomes by comparing changes from baseline in the Fahn-Tolosa-Marin Tremor Rating Scale Part B (FTM-B) for the treated limb between patients with ET and ET-plus at follow-up examinations. Patients were re-classified as having ET or ET-plus using pre-operative examination videos by two independent movement disorders neurologists blinded to patient characteristics. As a secondary outcome, we evaluated for correlations and potential predictors of treatment response.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Twenty-six patients were included: 13 with ET, 13 with ET-plus. There were no significant differences in the change in FTM-B scores between the ET and ET-plus patients at each follow-up examination. None of the included patients developed new symptoms compatible with dystonia, parkinsonism or gait disturbances.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Patients with ET-plus had tremor improvement from VIM DBS, with no differences when compared to those with ET, without emergence of postoperative neurological issues. Patients with ET-plus should still be considered good candidates for VIM DBS for treatment of tremor.<\/jats:p>","DOI":"10.3389\/fneur.2021.790027","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T13:07:15Z","timestamp":1638364035000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Response to Thalamic Ventralis Intermedius Nucleus Deep Brain Stimulation in Essential Tremor vs. Essential Tremor-Plus"],"prefix":"10.3389","volume":"12","author":[{"given":"Gabriela S.","family":"Gilmour","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Martino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Hunka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pia","family":"Lawrence","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zelma H. T.","family":"Kiss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"Bruno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1056\/NEJMcp010928","article-title":"Clinical practice. Essential tremor","volume":"345","author":"Louis","year":"2001","journal-title":"N Engl J Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1002\/mds.10221","article-title":"Essential tremor: a heterogenous disorder","volume":"17","author":"Jankovic","year":"2002","journal-title":"Mov Disord."},{"key":"B3","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1002\/mds.27121","article-title":"Consensus statement on the classification of tremors. From the task force on tremor of the International Parkinson and Movement Disorder Society","volume":"33","author":"Bhatia","year":"2018","journal-title":"Mov Disord."},{"key":"B4","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1093\/brain\/117.4.805","article-title":"A study of hereditary essential tremor","volume":"117","author":"Bain","year":"1994","journal-title":"Brain."},{"key":"B5","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1016\/j.neubiorev.2019.10.021","article-title":"Psychosocial factors and perceived tremor disability in essential tremor","volume":"108","author":"Thangavelu","year":"2020","journal-title":"Neurosci Biobehav Rev"},{"key":"B6","doi-asserted-by":"publisher","first-page":"972","DOI":"10.1111\/j.1468-1331.2010.03295.x","article-title":"The psychosocial burden of essential tremor in an outpatient- and a community-based cohort","volume":"18","author":"Lorenz","year":"2011","journal-title":"Eur J Neurol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1007\/s00415-012-6628-x","article-title":"Treatment of essential tremor: a systematic review of evidence and recommendations from the Italian Movement Disorders Association","volume":"260","author":"Zappia","year":"2013","journal-title":"J Neurol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/S1474-4422(10)70322-7","article-title":"Treatment of patients with essential tremor","volume":"10","author":"Deuschl","year":"2011","journal-title":"Lancet Neurol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1056\/NEJMoa1600159","article-title":"A randomized trial of focused ultrasound thalamotomy for essential tremor","volume":"375","author":"Elias","year":"2016","journal-title":"N Engl J Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1056\/NEJM200002173420703","article-title":"A comparison of continuous thalamic stimulation and thalamotomy for supression of severe tremor","volume":"342","author":"Schurrman","year":"2000","journal-title":"N Engl J Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1550","DOI":"10.1002\/mds.23195","article-title":"Deep brain stimulation for essential tremor: a systematic review","volume":"25","author":"Della Flora","year":"2010","journal-title":"Mov Disord."},{"key":"B12","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1136\/jnnp-2013-304943","article-title":"The safety and efficacy of thalamic deep brain stimulation in essential tremor: 10 years and beyond","volume":"85","author":"Baizabal-Carvallo","year":"2014","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B13","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1159\/000029728","article-title":"Tolerance and tremor rebound following long-term chronic thalamic stimulation for Parkinsonian and essential tremor","volume":"72","author":"Hariz","year":"1999","journal-title":"Stereotact Funct Neurosurg."},{"key":"B14","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1002\/mds.1089","article-title":"Long-term safety and efficacy of unilateral deep brain stimulation of the thalamus in essential tremor","volume":"16","author":"Koller","year":"2001","journal-title":"Mov Disord."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1601","DOI":"10.1212\/01.WNL.0000096012.07360.1C","article-title":"Long-term follow-up of thalamic deep brain stimulation for essential and parkinsonian tremor","volume":"61","author":"Kumar","year":"2003","journal-title":"Neurology."},{"key":"B16","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1016\/j.parkreldis.2013.03.006","article-title":"Loss of benefit in VIM thalamic deep brain stimulation (DBS) for essential tremor(ET): How prevalent is it?","volume":"19","author":"Shih","year":"2013","journal-title":"Park Relat Disord."},{"key":"B17","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1002\/mds.870090212","article-title":"Gait abnormality in essential tremor","volume":"9","author":"Singer","year":"1994","journal-title":"Mov Disord."},{"key":"B18","volume-title":"Atlas for Stereotaxy of the Human Brain.","author":"Schaltenbrand","year":"1977"},{"key":"B19","unstructured":"Vol. 2, Parkinson's Disease and Movement Disorders271280\n            FahnS\n            TolosaE\n            MarinC\n          Baltimore, MDWilliams and WilkinsClinical rating scale for tremor1993"},{"key":"B20","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1016\/j.brs.2017.12.014","article-title":"Predictors of deep brain stimulation outcome in tremor patients","volume":"11","author":"Sandoe","year":"2018","journal-title":"Brain Stimul."},{"key":"B21","doi-asserted-by":"publisher","first-page":"e1073","DOI":"10.1212\/WNL.0000000000008875","article-title":"Longitudinal follow-up with VIM thalamic deep brain stimulation for dystonic or essential tremor","volume":"94","author":"Tsuboi","year":"2020","journal-title":"Neurology."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/brainsci10120970","article-title":"Thalamic deep brain stimulation in essential tremor plus is as effective as in essential tremor","volume":"10","author":"Steffen","year":"2020","journal-title":"Brain Sci."},{"key":"B23","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1016\/j.parkreldis.2019.08.008","article-title":"Dystonia as complication of thalamic neurosurgery","volume":"66","author":"Picillo","year":"2019","journal-title":"Park Relat Disord"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.parkreldis.2019.11.019","article-title":"Dystonia following thalamic neurosurgery: a single centre experience with MR-guided focused ultrasound thalamotomy","volume":"71","author":"Martino","year":"2020","journal-title":"Park Relat Disord"},{"key":"B25","doi-asserted-by":"publisher","first-page":"E1378","DOI":"10.1212\/WNL.0000000000007134","article-title":"Long-term efficacy of deep brain stimulation for essential tremor: an observer-blinded study","volume":"92","author":"Paschen","year":"2019","journal-title":"Neurology."},{"key":"B26","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1093\/neuros\/nyab095","article-title":"Thalamic deep brain stimulation for spasmodic dysphonia: a phase i prospective randomized double-blind crossover trial","volume":"89","author":"Honey","year":"2021","journal-title":"Neurosurgery."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.790027\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T13:07:18Z","timestamp":1638364038000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.790027\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,29]]},"references-count":26,"alternative-id":["10.3389\/fneur.2021.790027"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2021.790027","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,29]]},"article-number":"790027"}}