Objectives

To determine change in restless legs syndrome (RLS) symptoms in essential tremor (ET) patients undergoing bilateral thalamic ventral intermedius (VIM) deep brain stimulation (DBS) surgery.

Materials and Methods

We retrospectively reviewed our database of ET patients with RLS who had undergone VIM DBS for tremor from 2012 to 2020. We reviewed the patients with available International Restless Leg Syndrome Study Group RLS scale scores before and after DBS. Percentage of responders, defined as proportion of patients experiencing three or more point improvement of RLS scores post-DBS, was calculated. We performed two-tailed t-test of pre-DBS and post-DBS RLS scores.

Results

We identified 13 patients with ET and RLS who had undergone bilateral VIM DBS, of whom nine (69%) were responders post-DBS. Five of 13 patients (38%) had complete resolution of RLS post-DBS. For all patients, mean pre-DBS RLS score was 15.8 ± 7.9 which improved by 46% post-DBS to a mean of 8.5 ± 8.8 (p = 0.007). Four patients rated their RLS scale one night with the stimulator OFF and another night with the stimulator ON. The mean RLS score with stimulator ON was 15.5 ± 7.6 which improved by 53% to a mean of 6.25 ± 7.8 (p = 0.008), with two having complete resolution of RLS with stimulator ON. Of the nine responders, six preferred to keep their stimulator ON at night due to relief of RLS and better subjective quality of sleep.

Conclusions

We report for the first time improvement of RLS in patients with ET after bilateral thalamic DBS. Although many ET patients with nonrechargeable DBS systems switch off their stimulator at night to conserve battery life, those with RLS may potentially benefit from keeping their stimulator ON at night to relieve their RLS.

中文翻译：

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丘脑深部脑刺激可改善原发性震颤患者的不宁腿综合征

目标

确定接受双侧丘脑腹侧中间肌 (VIM) 深部脑刺激 (DBS) 手术的特发性震颤 (ET) 患者的不安腿综合征 (RLS) 症状的变化。

材料和方法

我们回顾性审查了我们的数据库，该数据库包含 2012 年至 2020 年因震颤而接受 VIM DBS 的 ET 患者。我们回顾了 DBS 前后可用的国际不安腿综合征研究组 RLS 量表评分的患者。计算了响应者的百分比，定义为 DBS 后 RLS 评分改善 3 点或以上的患者比例。我们对 DBS 前和 DBS 后 RLS 分数进行了双尾 t 检验。

结果

我们确定了 13 名接受过双侧 VIM DBS 的 ET 和 RLS 患者，其中 9 名 (69%) 是 DBS 后的反应者。13 名患者中有 5 名 (38%) 在 DBS 后完全缓解了 RLS。对于所有患者，DBS 前平均 RLS 评分为 15.8 ± 7.9，DBS 后改善了 46%，平均为 8.5 ± 8.8 ( p  = 0.007)。四名患者在刺激器关闭的情况下和另一晚在刺激器打开的情况下对他们的 RLS 量表进行评分。刺激器打开时的平均 RLS 评分为 15.5 ± 7.6，提高了 53%，平均为 6.25 ± 7.8 ( p  = 0.008)，其中两个在刺激器打开时完全解决了 RLS。在九名响应者中，六名更喜欢在晚上保持刺激器开启，因为 RLS 缓解和更好的主观睡眠质量。

结论

我们首次报告了双侧丘脑 DBS 后 ET 患者 RLS 的改善。尽管许多使用不可充电 DBS 系统的 ET 患者在夜间关闭刺激器以延长电池寿命，但患有 RLS 的患者可能会从夜间保持刺激器开启以缓解其 RLS 中受益。