Responsive Deep Brain Stimulator for Essential Tremor

Exclusion Criteria

• •1. Any previous neurosurgical intervention including deep brain stimulation or ablative brain lesions.
• •2. Medication related movement disorders.
• •3. Any suspicion of Parkinsonian tremor, including presence of Parkinsonian features such as bradykinesia, rigidity, or postural instability.
• •4. Any behaviors consistent with ethanol or substance abuse as defined by the criteria outlined in DSM-V.
• •5. Severe medical co-morbidity including cardiovascular disorder, lung disorder, kidney disease, continuous neurological disease, hematological disease, or frailty that impact tolerability of the surgery as judged by the screening physicians.
• •6. Abnormal brain MRI including hydrocephalus, stroke, structural lesions, demyelinating lesions, or infectious lesions. Also excluded will be subjects with severe atrophy.
• •7. Any uncontrolled symptoms or signs of increased intracranial pressure (e.g., headache, nausea, vomiting, lethargy, papilledema).
• •8. A history of seizures within the past year.
• •9. A dementia rating scale score (DRS) \<130 signifying significant cognitive dysfunction and a potential for inability to cooperate with tasks involved in the study.
• •10. Any attempt or intent of suicide in the last six months.
• •11. Presence or history of psychosis.
• •12. Significant or active mood disorders including depression. For the purpose of this study, we consider a significant mood disorder to include any subject who has:
• •1. Scores ≥ 20 on the Patient Health Questionnaire - 9 (PHQ-9).
• •2. Currently under the care of a psychiatrist
• •3. Currently participating in cognitive-behavioral therapy
• •4. Been hospitalized for the treatment of a psychiatric illness within 12 months
• •5. Ever received transcranial magnetic stimulation
• •6. Ever received electroconvulsive therapy
• •n. In addition, patients who are pregnant or plan to become pregnant will be excluded from this study.