Bilateral caudal zona incerta nucleus stimulation for essential tremor: outcome and quality of life

Abstract
Background Over the past few years, bilateral stimulation of the caudal or motor part of the zona incerta nucleus (cZI) has been performed by the authors in patients with essential tremor (ET). Outcomes including quality of life data in 15 patients with a follow-up period of up to 84 months (mean 31.7±28.6 months) are presented. Methods 15 consecutive ET patients underwent MRI guided bilateral cZI deep brain stimulation implantation. Patients were assessed by applying the Fahn–Tolosa–Marin Tremor Rating Scale and the Short Form Health Survey-36 (SF-36) to assess quality of life. Results The total tremor score improved by 73.8% (pConclusion Bilateral cZI stimulation is safe and effective in suppressing the postural and action component of ET. It is associated with a low incidence of stimulation related complications and patients do not develop tolerance to stimulation with maintained clinical benefit over a follow-up period of up to 7 years.