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Kai-Liang Wang Joshua K. Wong Robert S. Eisinger Samuel Carbunaru Christine Smith Wei Hu Aparna Wagle Shukla Christopher W. Hess Michael S. Okun Adolfo Ramirez-Zamora 《Neuromodulation》2022,25(6):796-803
ObjectiveWe aimed to formulate a practical clinical treatment algorithm for Holmes tremor (HT) by reviewing currently published clinical data.Materials and MethodsWe performed a systematic review of articles discussing the management of HT published between January 1990 and December 2018. We examined data from 89 patients published across 58 studies detailing the effects of pharmacological or surgical interventions on HT severity. Clinical outcomes were measured by a continuous 1-10 ranked scale. The majority of studies addressing treatment response were case series or case reports. No randomized control studies were identified.ResultsOur review included 24 studies focusing on pharmacologic treatments of 25 HT patients and 34 studies focusing on the effect of deep brain stimulation (DBS) in 64 patients. In the medical intervention group, the most commonly used drugs were levetiracetam, trihexyphenidyl, and levodopa. In the surgically treated group, the thalamic ventralis intermedius nucleus (VIM) and globus pallidus internus (GPi) were the most common brain targets for neuromodulation. The two targets accounted for 57.8% and 32.8% of total cases, respectively. Overall, compared to the medically treated group, DBS provided greater tremor suppression (p = 0.025) and was more effective for the management of postural tremor in HT. Moreover, GPi DBS displayed greater benefit in the resting tremor component (p = 0.042) and overall tremor reduction (p = 0.022).ConclusionsThere is a highly variable response to different medical treatments in HT without randomized clinical trials available to dictate treatment decisions. A variety of medical and surgical treatment options can be considered for the management of HT. Collaborative research between different institutions and researchers are warranted and needed to improve our understanding of the pathophysiology and management of this condition. In this review, we propose a practical treatment algorithm for HT based on currently available evidence. 相似文献
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Tsuboi Takashi Wong Joshua K. Almeida Leonardo Hess Christopher W. Wagle Shukla Aparna Foote Kelly D. Okun Michael S. Ramirez-Zamora Adolfo 《Journal of neurology》2020,267(5):1278-1290
Journal of Neurology - To analyze deep brain stimulation (DBS) outcomes in patients with cervical dystonia (CD), the relationships between motor and disability/pain outcomes, and the differences in... 相似文献
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Takashi Tsuboi MD PhD Marc Charbel PhD David T. Peterside BS Mohit Rana PhD Ahmad Elkouzi MD Wissam Deeb MD Adolfo Ramirez-Zamora MD Janine Lemos Melo Lobo Jofili Lopes MD Leonardo Almeida MD Pamela R. Zeilman APRN Robert S. Eisinger PhD Kelly D. Foote MD Lela Okromelidze MD Sanjeet S. Grewal MD Michael S. Okun MD Erik H. Middlebrooks MD 《Movement disorders》2021,36(2):380-388
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