Deep brain stimulation for multiple sclerosis tremor: A systematic review and meta-analysis

Alireza Zali; Reza Jalili Khoshnood; Mahsa Motavaf; Alireza Salimi; Meisam Akhlaghdoust; Saeid Safari; Mahsa Ghajarzadeh; Omid Mirmosayyeb

doi:10.1016/j.msard.2021.103256

Deep brain stimulation for multiple sclerosis tremor: A systematic review and meta-analysis

Mult Scler Relat Disord. 2021 Nov:56:103256. doi: 10.1016/j.msard.2021.103256. Epub 2021 Sep 6.

Authors

Alireza Zali¹, Reza Jalili Khoshnood¹, Mahsa Motavaf¹, Alireza Salimi², Meisam Akhlaghdoust¹, Saeid Safari³, Mahsa Ghajarzadeh⁴, Omid Mirmosayyeb⁵

Affiliations

¹ Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² Department of Anesthesiology and Critical Care, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: drsafari.s@gmail.com.
⁴ Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN), Tehran University of Medical Sciences, Tehran, Iran.
⁵ Department of Neurology, School of medicine, Isfahan University of medical sciences, Isfahan, Iran, Isfahan Neurosciences Research Center, Isfahan University of medical sciences, Isfahan, Iran.

PMID: 34517191
DOI: 10.1016/j.msard.2021.103256

Abstract

Objective: This systematic review and meta-analysis aims to evaluate efficacy of deep brain stimulation (DBS) in treating MS-related tremor.

Methods: We systematically searched PubMed, Web of Science, Embase, Scopus, Google Scholar, and gray literature using a search strategy including the MeSH and text words as (((Brain Stimulations) OR (Deep Brain Stimulations) OR (Deep Brain Stimulations) OR (Deep Brain Brain Stimulation) OR (Deep Electrical Stimulation of the Brain)) AND (Multiple Sclerosis OR Sclerosis, Multiple) OR Sclerosis, Disseminated) OR Disseminated Sclerosis) OR MS (Multiple Sclerosis)) OR Multiple Sclerosis, Acute Fulminating).

Results: The literature search revealed 1663 articles, 1027 of which remained after removing duplicates. Seventeen articles, published between 1999-2018, were included for the meta-analysis, including overall 168 patients. Follow-up time ranged between 6-62 months. The pooled frequency of tremor improvement among the enrolled patients was 73%, (95% CI:64-83%) (I²=84.1%, p<0.001). The pooled standardized mean difference (SMD) (after -before) was -2.9, (95% CI:-4.8, -0.98) (I²=89.8%, p<0.001).

Conclusion: The results of this systematic review and meta-analysis demonstrate MS-related tremor improvement after DBS.

Keywords: Deep brain stimulation; Multiple sclerosis; Tremor.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Deep Brain Stimulation*
Humans
Multiple Sclerosis* / therapy
Tremor / therapy