MDS Abstracts

Abstracts from the International Congress of Parkinson’s and Movement Disorders.

MENU 
  • Home
  • Meetings Archive
    • 2024 International Congress
    • 2023 International Congress
    • 2022 International Congress
    • MDS Virtual Congress 2021
    • MDS Virtual Congress 2020
    • 2019 International Congress
    • 2018 International Congress
    • 2017 International Congress
    • 2016 International Congress
  • Keyword Index
  • Resources
  • Advanced Search

Is directional stimulation of the VIM superior to omnidirectional stimulation in patients with essential tremor?

S. Fliegen, P. Nikolov, C. Hartmann, P. Slotty, J. Vesper, A. Schnitzler, S. Groiß (Düsseldorf, Germany)

Meeting: 2019 International Congress

Abstract Number: 1402

Keywords: Deep brain stimulation (DBS), Tremors: Treatment

Session Information

Date: Tuesday, September 24, 2019

Session Title: Tremor

Session Time: 1:45pm-3:15pm

Location: Les Muses Terrace, Level 3

Objective: To determine whether directional stimulation of the VIM is superior to omnidirectional stimulation in essential tremor.

Background: Deep brain stimulation (DBS) of the VIM is a well-established therapy in the management of essential tremor but is frequently associated with side effects like gait ataxia. Directional current steering may be a way to activate fiber tracts more selectively, thereby widening the therapeutic window.

Method: For this prospective, randomized, double blind study 10 patients with ET (5 men, 5 women) treated with chronic deep brain stimulation (DBS) of the ventral intermediate thalamic nucleus (VIM) were recruited. To compare efficacy of current steering in VIM-DBS, therapeutic window was calculated under directional (3 directions) and omnidirectional stimulation by determining effect and adverse effect thresholds. Clinical efficacy was assessed by comparing impact of directional and omnidirectional stimulation settings on tremor rating scales (TRS, TETRAS), ataxia rating scales (mICARS, SARA) and accelerometry (Kinesia©). Total electrical energy delivered (TEED) was measured under both conditions.

Results: Therapeutic window under best directional stimulation tended to be wider than under omnidirectional stimulation. This resulted from a significantly lower effect threshold under best directional stimulation compared to omnidirectional stimulation, while there was no difference in terms of adverse effects. Best and second-best directional stimulation had a significantly wider therapeutic window than the third-best directional stimulation. In terms of clinical efficacy, we did not find significant differences. TEED at the adverse effect threshold was significantly higher under directional than under omnidirectional stimulation.

Conclusion: Directional stimulation is at least equally effective, compared to omnidirectional stimulation. Regarding effect threshold, our data even suggest a superiority of directional stimulation settings. Moreover, superiority of certain directions of stimulation may indicate a directional stimulation to be advantageous in case a DBS lead is not optimally placed. Under directional stimulation higher energy levels are needed to evoke adverse effects than under omnidirectional stimulation.

To cite this abstract in AMA style:

S. Fliegen, P. Nikolov, C. Hartmann, P. Slotty, J. Vesper, A. Schnitzler, S. Groiß. Is directional stimulation of the VIM superior to omnidirectional stimulation in patients with essential tremor? [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/is-directional-stimulation-of-the-vim-superior-to-omnidirectional-stimulation-in-patients-with-essential-tremor/. Accessed July 6, 2025.
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/is-directional-stimulation-of-the-vim-superior-to-omnidirectional-stimulation-in-patients-with-essential-tremor/

Most Viewed Abstracts

  • This Week
  • This Month
  • All Time
  • Covid vaccine induced parkinsonism and cognitive dysfunction
  • What is the appropriate sleep position for Parkinson's disease patients with orthostatic hypotension in the morning?
  • Welcome to the MDS Abstracts Site
  • Life expectancy with and without Parkinson’s disease in the general population
  • Nilotinib for treating MSA: A preclinical proof of concept study
  • Covid vaccine induced parkinsonism and cognitive dysfunction
  • Life expectancy with and without Parkinson’s disease in the general population
  • What is the appropriate sleep position for Parkinson's disease patients with orthostatic hypotension in the morning?
  • An atypical and interesting feature of Parkinson´s disease
  • Increased Risks of Botulinum Toxin Injection in Patients with Hypermobility Ehlers Danlos Syndrome: A Case Series
  • What is the appropriate sleep position for Parkinson's disease patients with orthostatic hypotension in the morning?
  • Help & Support
  • About Us
  • Cookies & Privacy
  • Wiley Job Network
  • Terms & Conditions
  • Advertisers & Agents
Copyright © 2025 International Parkinson and Movement Disorder Society. All Rights Reserved.
Wiley