Effect of Cycling Thalamosubthalamic Stimulation on Tremor Habituation and Rebound in Parkinson Disease.

Abstract

Deep brain stimulation is an effective treatment for severe tremor in essential tremor and Parkinson disease (PD). However, progressive loss of the beneficial effects of deep brain stimulation may occur due to several factors. We assessed the effects of different temporal patterns of cycling stimulation in the posterior subthalamic area, subthalamic nucleus, and the ventral intermediate nucleus of the thalamus in 3 PD patients with early decline of tremor suppression associated with severe tremor rebound. Certain temporal patterns of cycling (10 seconds on/1 second off or 30 seconds on/5 seconds off, soft start off) were useful for treating tremor habituation and rebound and showed long-term tremor suppression. Cycling stimulation may prevent tremor habituation in PD patients with severe tremor rebound.