IMPROVEMENTS IN DAILY FUNCTIONING AFTER DEEP BRAIN-STIMULATION OF THETHALAMUS FOR INTRACTABLE TREMOR

Deep brain stimulation (DBS) of the thalamus reduces tremor in patient s with essential tremor (ET). However, few studies have determined the degree of improvement in daily functioning associated with DBS. We de veloped a self-report Tremor Activities of Daily Living Scale (TADLS) to compare daily functioning with the stimulator turned on and off. Pa tients rated their performance on the 30 items of the TADLS with the s timulator turned off and then on. They also performed 10 activities un der the supervision of a clinician who rated their functional ability with stimulation off and then on. There was a 58% improvement in self- rated TADLS scores in patients with DBS with the stimulator on compare d with stimulation off. When activities were rated by the clinician, t he average improvement in functioning with the stimulator on was 54%. There were reasonably high correlations between patient and clinician ratings of functioning. ET patients have a marked improvement in daily functioning with thalamic DBS.