Dysgeusia in deep brain stimulation for essential tremor.

Publication Title

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

Authors

Jonathan Dennis Carlson, Inland Neurosurgery and Spine Associates, 105 West 8th Ave. Suite 200, Spokane, WA 99204Follow
Kate Elizabeth McLeod, Inland Neurosurgery and Spine Associates, 105 West 8th Ave. Suite 200, Spokane, WA 99204Follow
Jamelyn Brooke Mark, Northwest Neurological, 610 South Sherman Street, Suite 201, Spokane, WA 99202, USAFollow
Pamela Sue McLeod, Inland Neurosurgery and Spine Associates, 105 West 8th Ave. Suite 200, Spokane, WA 99204Follow
Beth Ann Bremer, Inland Neurosurgery and Spine Associates, 105 West 8th Ave. Suite 200, Spokane, WA 99204Follow

Document Type

Article

Publication Date

4-1-2018

Keywords

Adverse effects; Deep brain stimulation; Essential tremor; Lateral thalamic nuclei; Taste perception; Adult; Aged; Deep Brain Stimulation/adverse effects; Deep Brain Stimulation/methods; Dysgeusia/epidemiology; Dysgeusia/etiology; Essential Tremor/therapy; Female; Humans; Male; Middle Aged Retrospective Studies; Thalamus

Abstract

Dysgeusia, or foul taste, is a rarely reported side effect in patients who have undergone deep brain stimulation (DBS) in the thalamus for essential tremor. This retrospective study evaluated the incidence, nature, neurophysiological and anatomical location of dysgeusia following DBS. Of 52 patients who had undergone DBS for essential tremor, eight (15%) reported dysgeusia, which was described as a "metallic," "sour," "foul," or "cold" taste in the mouth. Dysgeusia was separate and distinguishable from paresthesia. Dysgeusia was more frequently reported with bilateral than unilateral DBS implants (6 of 27 (22%) vs. 2 of 25 (8%) patients, respectively). The anatomical locations of the contacts causing dysgeusia were measured on postoperative MRI, and compared to those from seven control patients who did not experience dysgeusia after receiving bilateral DBS implants. Leads causing dysgeusia were more posterior than non-dysgeusia-associated leads (4.5 ± 1.2 vs. 5.7 ± 1.8 mm anterior to the posterior commissure, respectively, P < .001). Intraoperative microelectrode recording indicated that these contacts were in the sensory region of the thalamus. Intraoperative testing found that low sensory threshold for paresthesia predicted the development of dysgeusia postoperatively (1.5 ± 0.5 V vs. 3.3 ± 1.9 V; P < .05). These data indicate that taste perception can be altered in the human through DBS, with posterior leads likely within the sensory region of the thalamus. Dysgeusia can be reduced by changing stimulation parameters, or surgical revision of the lead.

Area of Special Interest

Neurosciences (Brain & Spine)

Specialty/Research Institute

Neurosciences