Objective:

The aim of this study is to present the result of Deep Brain Stimulation in GPi (Globus pallidus internus) and VA (Ventral anterior nucleus of the thalamus) in a patient with progressive cerebellar atrophy of unknown etiology.

Background:

While deep brain stimulation (DBS) has been shown to be effective in disorders of basal ganglia origin, its use for cerebellar origin disorders remains relatively less understood.  This case study presents a patient with dystonic tremor, ataxia, and psychiatric symptoms associated with cerebellar atrophy of unknown etiology.  The patient was treated with DBS implantation in GPi and VA.  Targets were selected using clinical observation and data obtained from stereo EEG depth electrode implantation and subsequent observation in an inpatient Neuromodulation Monitoring Unit (NMU).

Method:

Pre and one-year post-operative scores were examined to determine improvement in symptoms using Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS), Barry Albright Dystonia Scale (BADS), Scale for Assessment and Rating of Ataxia (SARA).

Results:

An improvement in movement symptomatology was seen one year after permanent electrode implantation and programming using the movement scales. BFMDRS movement pre-15.5, post-8; BFMDRS disability pre-13, post-8; BADS pre-14, post-7; SARA pre-20.5, post-14.5.

Conclusion:

DBS can have beneficial effects on multiple symptoms associated with cerebellar degeneration.  We cannot exclude the possibility of other neurological deficits in this patient, and thus the effect of DBS could be mediated through multiple mechanisms. This case report suggests the need for further exploration of the role of DBS in cerebellar-origin disorders.

Table 1

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MDS Abstracts - https://www.mdsabstracts.org/abstract/case-report-effect-of-dbs-in-a-patient-with-cerebellar-atrophy/