Lesion surgery versus deep brain stimulation in patients with tremor

This study compared the use of deep brain stimulation (DBS) and lesion surgery (LS) in the treatment of tremor. This study found that LS and DBS were equally effective in these patients.

Tremor is an involuntary movement of a body part. It is commonly a symptom in Parkinson's disease (PD). It can also be found in other conditions such as essential tremor (ET) and multiple sclerosis (MS). Treatments for tremors caused by these illnesses can include surgery. Deep brain stimulation (DBS) and lesion surgery (LS) are two surgical treatments. DBS involves putting electrodes into the brain to stimulate the nerves. LS destroys a targeted area of the brain affected by PD. The object is to destroy tissue that produces abnormal chemical or electrical impulses that cause tremors and other symptoms of PD. LS can be carried out using ultrasound or using cauterising tips.  

It is unclear if DBS or LS is the better treatment option for tremor.

This study analyzed 15 other studies comparing DBS and LS in patients with tremor. Overall, 1508 patients were included. Tremor score, quality of life and cognitive (thinking and memory) function were examined after treatments.

Overall, there was no significant difference in change of tremor scale, quality of life or cognitive function between DBS and LS groups. People who had a tremor for a longer period of time had worse quality of life. Focused ultrasound LS treatment was associated with an improvement in the quality of life as compared to DBS. 

This study found that LS and DBS were equally effective in the treatment of patients with tremor. However, LS delivered by focused ultrasound was associated with a better quality of life.

This study analyzed data from studies with different protocols. Further prospective comparative studies are needed.