Dual Thalamic Stimulation for Disabling Multiple Sclerosis Tremor

Severe multiple sclerosis (MS) tremor is a disabling and challenging symptom to treat (NEJM Journal Watch Neurol 2012 Sep). Several prior studies have evaluated deep brain stimulation (DBS) for MS tremor. The present investigators compared baseline tremor with single and dual stimulation of two regions within the thalamus: the traditional ventralis intermedius (VIM) and the more novel ventralis oralis (VO). The rationale was to have a more durable benefit without long-term worsening by using the VO lead stimulation in addition to the VIM lead. In this single-center study, 12 patients were randomized to receive 3 months of either VIM or VO deep brain stimulation, followed by 3 months of open-label dual VIM/VO stimulation. The primary outcome…