OBJECTIVES To analyze the long-term efficacy and cognitive effects of voltage-based deep brain stimulation (DBS) for drug-resistant essential tremor (ET). PATIENTS AND METHODS Patients with drug-resistant ET and treated by voltage-based DBS of the ventral intermediate nucleus (VIM-DBS) were continuously enrolled. Seizure outcomes were assessed by blinded observers using the Tremor Rating Scale (TRS). The full-scale intelligence quotient, full-scale memory quotient, Hamilton Depression Scale, Hamilton Anxiety Scale, and Quality of Life in Essential Tremor Questionnaire were assessed as measures of cognitive function. RESULTS Eleven patients met the inclusion criteria, and two of them were excluded because of loss to follow-up. The patient follow-up times ranged from 48 to 66 months (median 51 months). TRS scores decreased by 60.4% and 46.0% at the 12- and 48-month follow-ups, respectively. Both changes were highly significant. During the follow-up period, the patients' intelligence and memory had not significantly changed; depression, anxiety, and quality of life significantly improved. After long-term follow-up, the stimulation efficacy and quality of life gradually decreased, and the depression and anxiety levels increased. CONCLUSION For patients with drug-resistant ET, voltage-based DBS can provide acceptable benefits on tremor, cognitive function, and quality of life. However, the efficacy of VIM-DBS decreased over time.

中文翻译：

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基于电压的脑深部刺激治疗耐药性特发性震颤的远期疗效和认知效应

目的 分析基于电压的脑深部电刺激 (DBS) 治疗耐药特发性震颤 (ET) 的长期疗效和认知影响。患者和方法 持续招募接受基于电压的腹中间核 DBS (VIM-DBS) 治疗的耐药 ET 患者。癫痫发作结果由盲观察者使用震颤评定量表 (TRS) 进行评估。全面智商、全面记忆商、汉密尔顿抑郁量表、汉密尔顿焦虑量表和基本震颤问卷中的生活质量被评估为认知功能的测量。结果 11 名患者符合纳入标准，其中 2 名因失访而被排除在外。患者随访时间为 48 至 66 个月（中位数为 51 个月）。TRS 分数下降了 60.4% 和 46。在 12 个月和 48 个月的随访中分别为 0%。这两个变化都非常显着。随访期间，患者的智力和记忆力无明显变化；抑郁、焦虑和生活质量显着改善。长期随访后，刺激效果和生活质量逐渐下降，抑郁和焦虑水平升高。结论 对于耐药性 ET 患者，基于电压的 DBS 可以在震颤、认知功能和生活质量方面提供可接受的益处。然而，VIM-DBS 的疗效随着时间的推移而下降。长期随访后，刺激效果和生活质量逐渐下降，抑郁和焦虑水平升高。结论 对于耐药性 ET 患者，基于电压的 DBS 可以在震颤、认知功能和生活质量方面提供可接受的益处。然而，VIM-DBS 的疗效随着时间的推移而下降。长期随访后，刺激效果和生活质量逐渐下降，抑郁和焦虑水平升高。结论 对于耐药性 ET 患者，基于电压的 DBS 可以在震颤、认知功能和生活质量方面提供可接受的益处。然而，VIM-DBS 的疗效随着时间的推移而下降。