The new essential tremor (ET) classification defined ET-plus (ET-p) as an ET subgroup with additional neurological signs besides action tremor. While deep brain stimulation (DBS) is effective in ET, there are no studies specifically addressing DBS effects in ET-p. 44 patients with medication-refractory ET and thalamic/subthalamic DBS implanted at our center were postoperatively classified into ET and ET-p according to preoperative documentation. Tremor suppression with DBS (stimulation ON vs. preoperative baseline and vs. stimulation OFF), measured via the Fahn–Tolosa–Marin tremor rating scale (TRS), stimulation parameters, and the location of active contacts were compared between patients classified as ET and ET-p. TRS scores at baseline were higher in ET-p. ET-p patients showed comparable tremor reduction as patients with ET, albeit higher stimulation parameters were needed in ET-p. Active electrode contacts were located more dorsally in ET-p of uncertain reason. Our data show that DBS is similarly effective in ET-p compared to ET. TRS scores were higher in ET-p preoperatively, and higher stimulation parameters were needed for tremor reduction compared to ET. The latter may be related to a more dorsal location of active electrode contacts in the ET-p group of this cohort. Prospective studies are warranted to investigate DBS in ET-p further.

中文翻译：

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在原发性震颤中丘脑深部脑刺激与原发性震颤一样有效

新的基本震颤（ET）分类将ET-plus（ET-p）定义为ET亚组，除了动作震颤外还具有其他神经系统症状。尽管深层脑刺激（DBS）在ET中有效，但尚无专门针对ET-p的DBS效应的研究。根据术前文献，将44例难治性ET和丘脑/丘脑DBS植入我们中心的患者术后分为ET和ET-p。通过Fahn-Tolosa-Marin震颤等级量表（TRS），刺激参数和活动性接触部位的测量比较了DBS对震颤的抑制作用（刺激ON与术前基线以及刺激OFF），比较了ET和ET-p。ET-p的基线TRS评分较高。ET-p患者的震颤减轻程度与ET患者相当，尽管ET-p需要更高的刺激参数。不确定原因，有源电极触点位于ET-p的更背面。我们的数据表明，与ET相比，DBS在ET-p中同样有效。术前ET-p的TRS评分较高，与ET相比，减少震颤需要更高的刺激参数。后者可能与该人群的ET-p组中的活性电极触点的背侧位置有关。有必要进行前瞻性研究以进一步研究ET-p中的DBS。后者可能与该人群的ET-p组中的活动电极触点的背侧位置有关。有必要进行前瞻性研究以进一步研究ET-p中的DBS。后者可能与该人群的ET-p组中的活动电极触点的背侧位置有关。有必要进行前瞻性研究以进一步研究ET-p中的DBS。