Parkinsonism & related disorders最新文献

{"title":"Effects of anodal cerebellar transcranial direct current stimulation on motor symptoms and cerebellar inhibition in Parkinson's disease: A sham-controlled cross-over study","authors":"Pierre Cabaraux ,&nbsp;Christian Georgiev ,&nbsp;Virginie Destrebecq ,&nbsp;Frédéric Supiot ,&nbsp;Nicolas Yanguma Muñoz ,&nbsp;Armin Hakkak Moghadam Torbati ,&nbsp;Daria Digileva ,&nbsp;Antonella Iannotta ,&nbsp;Esranur Yildiran Carlak ,&nbsp;Scott Mongold ,&nbsp;Mathieu Bourguignon ,&nbsp;Gilles Naeije","doi":"10.1016/j.parkreldis.2026.108202","DOIUrl":"10.1016/j.parkreldis.2026.108202","url":null,"abstract":"<div><h3>Background</h3><div>Growing evidence suggests that the cerebellum contributes to the motor symptoms observed in Parkinson's disease (PD), possibly through altered cerebellar brain inhibition (CBI). Enhancing CBI may therefore represent a potential approach to alleviate motor symptoms in PD.</div></div><div><h3>Objective</h3><div>This study evaluated the acute effects of a single session of anodal cerebellar transcranial direct current stimulation (acTDCS) on motor evoked potential (MEP) amplitude and motor symptoms in PD.</div></div><div><h3>Methods</h3><div>Twenty-two participants with PD participated in a randomized, crossover trial receiving both real and sham acTDCS a minimum of 2 weeks apart. Motor performance was assessed using the MDS-UPDRS Part III before and after each session. MEPs were recorded at 3 time points of each session: before, during, and after acTDCS. ANOVAs and paired t-tests were used to assess the effect of time point and acTDCS on MEPs amplitude and latency and MDS-UPDRS Part III.</div></div><div><h3>Results</h3><div>Real acTDCS significantly improved MDS-UPDRS III scores compared to sham (−2.36 vs. −0.55; <em>p</em> &lt; 0.001). Compared to the pre-acTDCS baseline, a significant reduction in MEP amplitude was observed during acTDCS (<em>p</em> = 0.014), specifically in the real condition (<em>p</em> = 0.009), but not in the sham condition (<em>p</em> = 0.063). No effect on MEPs latency was observed.</div></div><div><h3>Conclusion</h3><div>A single session of acTDCS appears to enhance cerebellar inhibition of motor cortex excitability, paralleling the CBI effect, as reflected by the reduced MEP amplitude during stimulation. It also improves motor symptoms, suggesting that this approach may represent a promising therapeutic strategy in PD.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"144 ","pages":"Article 108202"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated assessment of susceptibility map-weighted imaging in patients with clinically uncertain parkinsonism","authors":"Elon D. Wallert ,&nbsp;Elsmarieke van de Giessen ,&nbsp;Martijn Beudel ,&nbsp;Tom van Mierlo ,&nbsp;Jeroen Blankevoort ,&nbsp;Henk W. Berendse ,&nbsp;Rob M.A. de Bie ,&nbsp;Jan Booij","doi":"10.1016/j.parkreldis.2026.108198","DOIUrl":"10.1016/j.parkreldis.2026.108198","url":null,"abstract":"<div><h3>Background and objectives</h3><div>In patients with a clinically uncertain parkinsonian syndrome (CUPS), the novel MRI sequence susceptibility map-weighted imaging (SMWI) may be a diagnostic alternative to dopamine transporter (DAT) imaging with the advantage of greater accessibility. This study aimed to assess the diagnostic accuracy of software analyzing SMWI in differentiating dopaminergic neurodegenerative from non-neurodegenerative parkinsonism in CUPS patients.</div></div><div><h3>Methods</h3><div>A diagnostic accuracy study was conducted, including patients presenting with CUPS who underwent DAT SPECT imaging. The index test was the result of AI-driven software (Heuron IPD version 1.0.1.9, Heuron Co., Ltd, Seoul, Korea), designed to classify the nigrosome-1 on SMWI acquired at 3T as normal or abnormal. The reference test was the final clinical diagnosis, incorporating findings from DAT SPECT imaging.</div></div><div><h3>Results</h3><div>A total of 176 patients were included in the final analysis; 82 received a final diagnosis of dopaminergic neurodegenerative parkinsonism, and 94 with non-neurodegenerative parkinsonism. The AI-driven SMWI software demonstrated a diagnostic accuracy of 86.9 % distinguishing neurodegenerative from non-neurodegenerative parkinsonism, with sensitivity of 92.7 % and specificity of 81.9 %.</div></div><div><h3>Discussion</h3><div>This study is the first to evaluate the diagnostic accuracy of software analyzing SMWI in patients presenting with CUPS. The findings highlight the promising diagnostic utility of SMWI in clinical practice for CUPS patients. Future studies are warranted as SMWI might be able to reduce the need for DAT-imaging in the future by offering a more accessible and cost-effective alternative.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"144 ","pages":"Article 108198"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends and risk factors of hospital readmission following deep brain stimulation for Parkinson disease","authors":"Daniel G. Di Luca ,&nbsp;Adam de Havenon ,&nbsp;Anagha Prabhune ,&nbsp;Joel Perlmutter ,&nbsp;Tamara Hershey ,&nbsp;Scott A. Norris","doi":"10.1016/j.parkreldis.2026.108196","DOIUrl":"10.1016/j.parkreldis.2026.108196","url":null,"abstract":"<div><h3>Background</h3><div>Risk factors and long-term data on readmissions following deep brain stimulation (DBS) for Parkinson Disease (PD) remain unclear.</div></div><div><h3>Objective</h3><div>To evaluate the temporal trend and risk factors associated with hospital readmission following DBS for PD.</div></div><div><h3>Methods</h3><div>We analyzed DBS procedures for PD in the National Readmissions Database (2016–2022). The association between demographic, clinical, and hospital factors with 90-day readmission following DBS was evaluated using a multivariable logistic and Cox regression models.</div></div><div><h3>Results</h3><div>Among 7535 DBS surgeries, 8.1 % individuals were readmitted within 90 days. Higher Elixhauser-Comorbidity Index and complicated diabetes mellitus were associated with a higher risk of 90-day readmission (adjusted odds ratio 1.60, 95 % CI 1.06–2.41). Readmissions did not statistically significantly change between 2016 and 2022.</div></div><div><h3>Conclusion</h3><div>The rate of non-elective readmissions following DBS for PD has not changed over time. A higher comorbidity index and complicated diabetes mellitus were identified as key risk factors.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"144 ","pages":"Article 108196"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical profile of idiopathic normal pressure hydrocephalus with reduced myocardial sympathetic nerve function","authors":"Shiho Matsubara ,&nbsp;Shigenori Kanno ,&nbsp;Toru Baba ,&nbsp;Yoshiyuki Nishio ,&nbsp;Chifumi Iseki ,&nbsp;Nobuko Kawakami ,&nbsp;Kazuo Kakinuma ,&nbsp;Hayato Odagiri ,&nbsp;Shoko Ota ,&nbsp;Keiko Endo ,&nbsp;Kentaro Takanami ,&nbsp;Shin-ichiro Osawa ,&nbsp;Tomohiro Kawaguchi ,&nbsp;Hidenori Endo ,&nbsp;Kyoko Suzuki","doi":"10.1016/j.parkreldis.2026.108213","DOIUrl":"10.1016/j.parkreldis.2026.108213","url":null,"abstract":"<div><h3>Introduction</h3><div>Findings of reduced cardiac sympathetic nerve function and pareidolic illusions have been useful for identifying Lewy body disease (LBD). Therefore, we aimed to investigate whether these findings are associated with a high prevalence of LBD-related symptoms and poor shunt responsiveness in patients with idiopathic normal pressure hydrocephalus (iNPH).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 104 iNPH patients who underwent preoperative ¹²³I-metaiodobenzylguanidine myocardial scintigraphy and the Pareidolia test. We divided the patients into the abnormal cardiac scan (AC) group and the normal cardiac scan (NC) group. The severity of gait, cognitive, and urinary disturbances; the prevalence of parkinsonism; the prevalence of behavioral and neuropsychiatric symptoms; and performance on neuropsychological assessments were compared between the two groups. Moreover, we investigated the changes in these measures after shunt surgery in each group.</div></div><div><h3>Results</h3><div>Fifty-six (53.8 %) patients were classified into the AC group. Compared with patients in the NC group, the patients in the AC group had more frequent rigidity, resting tremor, hallucinations, and REM sleep behavior disorder, and greater deficits in attention, working memory, and visuospatial cognition. After shunt surgery, gait and urinary functions significantly improved in both groups. However, unlike in the NC group, no significant improvement in cognitive function was observed in the AC group.</div></div><div><h3>Conclusions</h3><div>Our results suggest that reduced cardiac sympathetic function in iNPH patients is linked to increased LBD-related clinical features and attenuated cognitive improvement after shunt surgery.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"144 ","pages":"Article 108213"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of hypokinetic dysarthria severity level on the long-term outcome of repetitive transcranial magnetic stimulation therapy","authors":"Krystof Novotny ,&nbsp;Lubos Brabenec ,&nbsp;Jiri Mekyska ,&nbsp;Andrea Moravska ,&nbsp;Pedro Gómez-Vilda ,&nbsp;Andrés Gómez-Rodellar ,&nbsp;Irena Rektorova","doi":"10.1016/j.parkreldis.2026.108175","DOIUrl":"10.1016/j.parkreldis.2026.108175","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypokinetic dysarthria (HD) is a common and disabling symptom of Parkinson's disease (PD) for which established pharmacological and surgical treatments bring only limited, often short-term improvement in speech. The aim of this study was to investigate whether the long-term acoustic effects of repetitive transcranial magnetic stimulation (rTMS) over the right superior temporal gyrus (STG) depend on the baseline severity of HD.</div></div><div><h3>Methods</h3><div>26 PD patients were randomized to active STG-targeted rTMS (<em>n</em> = 15) or sham stimulation (<em>n</em> = 11) and followed across five recording sessions over 14 weeks, alongside one session of matched healthy controls. HD</div><div>severity at baseline was quantified using 3F test subscores and used to stratify patients into milder (0) and more severe (1) subgroups. The STG 1 subgroup combined greater motor and speech impairment with shorter disease duration. Multiple acoustic features from sustained phonation and free monologue were extracted, normalized to controls, adjusted for sex, and analyzed using non-parametric statistics and descriptive visualisations.</div></div><div><h3>Results</h3><div>Patients with more severe HD receiving active stimulation (STG 1) showed consistent, long-lasting improvements in phonation-related parameters, whereas milder HD (STG 0) and sham groups (SHAM 0, SHAM 1) exhibited only limited or transient changes.</div></div><div><h3>Conclusion</h3><div>Given this observation, STG-targeted rTMS appears particularly beneficial for PD patients with more advanced HD, supporting auditory–motor network modulation as a therapeutic strategy and motivating larger, multi-centre trials to confirm these stratified effects and their clinical impact.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"144 ","pages":"Article 108175"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subjective cognitive complaints in cognitively normal patients with Parkinson's disease predict development of dementia: A 5-year longitudinal observation","authors":"Han-Kyeol Kim ,&nbsp;Min Seok Baek ,&nbsp;Jeehyun Ham ,&nbsp;Jin Yong Hong","doi":"10.1016/j.parkreldis.2026.108179","DOIUrl":"10.1016/j.parkreldis.2026.108179","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to examine whether subjective cognitive complaints (SCCs) measured by the SCCQ-PD questionnaire can predict the development of dementia in initially cognitively normal patients with Parkinson's disease (PD).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 53 PD patients with normal cognition at baseline who were followed for an average of 5 years. SCCs were assessed using the SCCQ-PD, a self-reported questionnaire, and subjects were classified into three tertile groups based on SCCQ-PD scores (score 0–2, 3–5, and 6–12). Cox proportional hazard models were used to identify predictors of dementia.</div></div><div><h3>Results</h3><div>Baseline demographic characteristics and cognitive performance did not differ significantly among groups, while patients with high tertile group (SCCQ-PD score 6–12) showed poorer instrumental activities of daily living than those with low tertile group (score 0–2). During follow-up, 17 (32.1 %) patients developed dementia. Patients with the high tertile group were significantly associated with an increased risk of future dementia (adjusted hazard ratio = 5.37; 95 % confidential interval, 1.33–21.67; <em>p</em> = 0.018) after controlling for age and disease duration at baseline.</div></div><div><h3>Conclusions</h3><div>SCCs assessed using the SCCQ-PD questionnaire may be associated with an increased risk of future dementia in cognitively normal patients with PD. Prospective validation in larger cohorts is required to confirm the predictive value of the SCCQ-PD.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"144 ","pages":"Article 108179"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subthalamic deep brain stimulation alleviates the gait sequence effect and freezing of gait in Parkinson's disease","authors":"Chuyi Cui ,&nbsp;Goun Je ,&nbsp;Kevin B. Wilkins ,&nbsp;Tilman Schulte ,&nbsp;Helen M. Bronte-Stewart","doi":"10.1016/j.parkreldis.2025.108062","DOIUrl":"10.1016/j.parkreldis.2025.108062","url":null,"abstract":"<div><h3>Background</h3><div>The sequence effect in gait—progressive shortening of strides—contributes to freezing of gait (FOG), a debilitating symptom of Parkinson's disease (PD). The sequence effect is refractory to dopaminergic medications and attentional strategies, with improvement observed only through external cueing. While subthalamic nucleus (STN) deep brain stimulation (DBS) is a standard treatment for PD, its efficacy for gait and FOG remains debated.</div></div><div><h3>Objective</h3><div>To characterize the sequence effect in spatiotemporal gait parameters in PD and to investigate the effects of STN-DBS.</div></div><div><h3>Methods</h3><div>Eighteen individuals with PD with bilateral STN-DBS and fourteen age-matched healthy controls performed a harnessed Stepping-In-Place task, validated to elicit FOG. PD participants were assessed OFF and ON DBS in the off-medication state. Gait kinematics were measured using shank IMU sensors. The sequence effect was quantified by fitting an exponential decay function to each spatiotemporal gait parameter prior to freezing.</div></div><div><h3>Results</h3><div>The sequence effect was evident in PD participants but not in healthy controls. It manifested as a progressive reduction in swing angular velocity and angular range over time, with variable trends in swing time. The severity of the sequence effect significantly correlated with percent time spent freezing off therapy (<em>p</em> &lt; 0.001). STN-DBS significantly alleviated the sequence effect (<em>p</em> = 0.002) and reduced percent time freezing (<em>p</em> = 0.01).</div></div><div><h3>Conclusions</h3><div>The Stepping-In-Place task elicited the sequence effect in PD, revealing progressive deterioration in both spatial and velocity aspects of gait, which contributed to the severity of FOG. STN-DBS effectively reduced the sequence effect, thereby improving FOG.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"144 ","pages":"Article 108062"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Verbal fluency in Parkinson's disease with mild cognitive impairment: quantitative, qualitative, and semantic network analyses","authors":"Alfonso Delgado-Álvarez ,&nbsp;Lucía Fernández-Romero ,&nbsp;María Valles-Salgado ,&nbsp;Cristina Delgado-Alonso ,&nbsp;María José Gil-Moreno ,&nbsp;Marta Palacios-Sarmiento ,&nbsp;Pablo Abizanda-Saro ,&nbsp;Jorge Matías-Guiu ,&nbsp;Rocío García-Ramos ,&nbsp;Jordi A. Matias-Guiu","doi":"10.1016/j.parkreldis.2026.108201","DOIUrl":"10.1016/j.parkreldis.2026.108201","url":null,"abstract":"<div><h3>Background</h3><div>Verbal fluency (VF) tasks are widely used in the cognitive assessment of Parkinson's disease (PD). However, the total number of correct responses does not capture all aspects of performance, and the underlying cognitive mechanisms remain unclear.</div></div><div><h3>Objective</h3><div>To compare semantic and phonemic VF performance in PD patients with mild cognitive impairment (PD-MCI) and those without cognitive impairment (PD-nCI).</div></div><div><h3>Methods</h3><div>Eighty participants with PD (50 % PD-MCI), no differences by sex, age, or education, completed a comprehensive neuropsychological battery and two verbal fluency tasks. The number of correct responses (CR), clusters, switches, mean cluster size, intrusions, and perseverations were compared between groups. Linear regression analyses were conducted to identify neuropsychological predictors of each VF measure. In addition, two semantic network maps were created for each group and compared both quantitatively and qualitatively.</div></div><div><h3>Results</h3><div>The PD-nCI group outperformed the PD-MCI group in CR on both tasks, as well as in the number of clusters and switches in semantic fluency, with large effect sizes. Episodic verbal memory, naming, and attention predicted semantic fluency performance, while attention, working memory, and executive functions predicted phonemic fluency. Semantic network analysis revealed significant differences in average shortest path length and clustering coefficient, with higher values in PD-nCI, whereas modularity coefficient did not differ. The PD-nCI network showed more numerous and clearly defined communities.</div></div><div><h3>Conclusion</h3><div>Participants with PD-MCI showed greater impairment in semantic fluency, with fewer clusters and switches. Semantic network analysis revealed alterations in the network structure of PD-MCI, indicating reduced local semantic cohesion.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"144 ","pages":"Article 108201"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chorea-acanthocytosis with homozygous variant of VPS13A gene concomitant with intermediate expansion of JPH3 gene: Who is the villain?","authors":"Dayany Leonel Boone ,&nbsp;Maria Carolina Soares ,&nbsp;Carolina Candeias da Silva ,&nbsp;Beatriz Azevedo dos Anjos Godke Veiga ,&nbsp;Vitor Tumas ,&nbsp;Thiago Yoshinaga Tonholo Silva ,&nbsp;José Luiz Pedroso ,&nbsp;Roberta Arb Saba Rodrigues Pinto ,&nbsp;Vanderci Borges ,&nbsp;Henrique Ballalai Ferraz","doi":"10.1016/j.parkreldis.2026.108200","DOIUrl":"10.1016/j.parkreldis.2026.108200","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"144 ","pages":"Article 108200"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior subthalamic area stimulation for essential tremor: Long-term efficacy and the challenging balance of stimulation-related side effects","authors":"Ines Debove ,&nbsp;Mara Beuster ,&nbsp;Mario Sousa ,&nbsp;Katrin Petermann ,&nbsp;Gerd Tinkhauser ,&nbsp;Julia Waskönig ,&nbsp;Andreas T. Diamantaras ,&nbsp;Andreas Nowacki ,&nbsp;Claudio Pollo ,&nbsp;Georg Kägi ,&nbsp;Paul Krack ,&nbsp;Martin Lenard Lachenmayer","doi":"10.1016/j.parkreldis.2026.108206","DOIUrl":"10.1016/j.parkreldis.2026.108206","url":null,"abstract":"<div><h3>Introduction</h3><div>Deep brain stimulation (DBS) targeting the posterior subthalamic area (PSA) is a more recent target to manage medication-refractory essential tremor (ET), with some studies suggesting enhanced tremor control and more favorable side-effects profile compared to traditional ventral intermediate nucleus (Vim). This study aims to assess the long-term efficacy and side effect profile of PSA-DBS in ET patients.</div></div><div><h3>Methods</h3><div>Fourteen ET patients who underwent bilateral PSA-DBS were evaluated using the Fahn-Tolosa-Marin Tremor Rating Scale preoperatively, at 12 months, and at the last follow-up (range 10–63 months). Within the first 6 months postoperatively, systematic monopolar contact testing was performed to determine individual thresholds for tremor suppression and adverse effects. Standardized neurological examinations and blinded video assessments were used to document stimulation-induced side effects.</div></div><div><h3>Results</h3><div>Tremor was significantly reduced postoperatively, allowing a 59% reduction at 12 months and 39% at last follow-up. Common side effects at last follow-up included dysarthria (93%), ataxia (57%), and gait disturbances (79%), mainly mild to moderate in severity. Additionally, stimulation-induced dyskinesia occurred in 21% of patients. Patient satisfaction remained high, with 85.7% reporting significant improvements.</div></div><div><h3>Conclusions</h3><div>Bilateral PSA-DBS demonstrates sustained tremor reduction but can frequently present stimulation-induced side-effects, highlighting the importance of careful long-term monitoring and programming adjustments.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"144 ","pages":"Article 108206"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}