AUTHOR=Martinez-Nunez Alfonso Enrique , Sarmento Filipe P. , Chandra Vyshak , Hess Christopher William , Hilliard Justin David , Okun Michael S. , Wong Joshua K. TITLE=Management of essential tremor deep brain stimulation-induced side effects JOURNAL=Frontiers in Human Neuroscience VOLUME=18 YEAR=2024 URL=https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2024.1353150 DOI=10.3389/fnhum.2024.1353150 ISSN=1662-5161 ABSTRACT=

Deep brain stimulation (DBS) is an effective surgical therapy for carefully selected patients with medication refractory essential tremor (ET). The most popular anatomical targets for ET DBS are the ventral intermedius nucleus (VIM) of the thalamus, the caudal zona incerta (cZI) and the posterior subthalamic area (PSA). Despite extensive knowledge in DBS programming for tremor suppression, it is not uncommon to experience stimulation induced side effects related to DBS therapy. Dysarthria, dysphagia, ataxia, and gait impairment are common stimulation induced side effects from modulation of brain tissue that surround the target of interest. In this review, we explore current evidence about the etiology of stimulation induced side effects in ET DBS and provide several evidence-based strategies to troubleshoot, reprogram and retain tremor suppression.