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

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) (I-2 =84.1, p<0.001). The pooled standardized mean difference (SMD) (after -before) was -2.9, (95 CI:-4.8, -0.98) (I-2 =89.8, p<0.001). Conclusion: The results of this systematic review and meta-analysis demonstrate MS-related tremor improvement after DBS.