Factors associated with receptivity to deep brain stimulation surgery among essential tremor cases

Elan D. Louis, Arthur Gillman

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: A sizable proportion of essential tremor (ET) patients suffer from medically-refractory ET. Although deep brain stimulation (DBS) surgery is a safe and highly effective treatment, it may be under-utilized. We are unaware of studies that assess ET patients' attitudes toward DBS surgery and the factors that motivate them toward or away from such surgery. Methods: ET cases, enrolled in an ongoing clinical-pathological study, underwent an in-person evaluation. They were asked "What is the likelihood that you would allow yourself to have DBS surgery?", thus rating their 'surgical receptivity' from 0 to 100. Results: One-third (47/146, 32.2%) of ET cases reported that they would consider DBS surgery. In univariate analyses, younger age (p = 0.017), self-reported embarrassment (p = 0.001), more depressive symptoms (p = 0.008), more dysthymia (p = 0.029), higher total tremor score (marginal p = 0.13) and lower burden of medical comorbidity (marginal p = 0.16) were associated with greater surgical receptivity. In multivariate logistic regression models, only self-reported embarrassment (p = 0.006) and, marginally, younger age (p = 0.059) were independently associated with surgical receptivity. Conclusions: We identified a number of factors that were associated with increased receptivity to DBS surgery. Interestingly, psychosocial variables (dysthymia, depressive symptoms, self-reported embarrassment) featured prominently among these factors; indeed, self-reported embarrassment was the most robust factor. Tremor severity, though associated in univariate analyses with increased surgical receptivity, was not as robust of a predictor as was self-reported embarrassment. Future studies, which are community-based as well as those which also assess the patient's level of understanding about DBS will further add to the literature on this topic.

Original languageEnglish (US)
Pages (from-to)482-485
Number of pages4
JournalParkinsonism and Related Disorders
Volume17
Issue number6
DOIs
StatePublished - Jul 2011
Externally publishedYes

Keywords

  • Clinical
  • Deep brain stimulation surgery
  • Embarrassment
  • Essential tremor

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

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