The Effect of Deep Brain Stimulation (DBS) for Voice Tremor in a Case of Essential Tremor

M. Tomifuji, K. Araki, A. Shiotani
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Abstract

Patients with voice tremor present with shaking voice which has a frequency of 4-5 Hz in their vocal tract. In most of cases, voice tremor is refractory to conservative treatment such as medication or voice therapy and the symptoms may affect a patient’s quality of life. We experienced a case of voice tremor accompanied by essential tremor of the upper extremities who was treated with bilateral thalamic deep brain stimulation (DBS). The results of an acoustic analysis and laryngeal endoscopic findings showed a partial improvement following unilateral DBS and complete improvement following bilateral DBS. FTRI, Fatr, ATRI, Jitter, Shimmer, vF0, vAm, NHR, sPPQ and sAPQ seemed to be useful parameters of voice tremor. The results suggest that the indication of DBS should be discussed for patients severely affected by voice tremor after considering the patient’s age, accompanying symptoms, backgrounds, occupation and needs.
脑深部电刺激(DBS)治疗原发性震颤患者声颤的效果
声道震颤患者表现为声音颤抖,声道频率为4-5赫兹。在大多数情况下,声音震颤是难以保守治疗,如药物或声音治疗,症状可能会影响患者的生活质量。我们经历了一例伴有原发性上肢震颤的声音震颤患者,他接受了双侧丘脑深部脑刺激(DBS)治疗。声学分析和喉内窥镜检查结果显示单侧DBS后部分改善,双侧DBS后完全改善。FTRI、Fatr、ATRI、Jitter、Shimmer、vF0、vAm、NHR、sPPQ和sAPQ似乎是声音震颤的有用参数。结果提示,对于重度声颤患者,应综合考虑患者的年龄、伴随症状、背景、职业、需求等因素,讨论DBS的适应证。
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