Movement Disorders最新文献

{"title":"Kinesin Light Chain 1–Related Spastic‐Dystonic Tetraparesis into Adulthood","authors":"Juan Dario Ortigoza‐Escobar, Itxaso Marti, Lara Pardina Vilella, Javier Ruiz Martínez, Carmen Espinós","doi":"10.1002/mds.70501","DOIUrl":"https://doi.org/10.1002/mds.70501","url":null,"abstract":"","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"50 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meridian Theory and the Interpretation of Randomized Evaluation","authors":"Shu‐Cheng Chen","doi":"10.1002/mds.70523","DOIUrl":"https://doi.org/10.1002/mds.70523","url":null,"abstract":"","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"40 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Costs of Parkinson's Disease in Europe: Results of the Costs of Illness in Neurology Initiative","authors":"Luisa Welter, Christopher Kruse, Mateo Montes‐Martinez, Paul Boon, Claudio Bassetti, Thomas Berger, Elena Moro, Maria Konti, Maria Lolich, Alessandro Tessitore, Amelia Hursey, Marjan Arvandi, Nikolai Mühlberger, Uwe Siebert, Richard Dodel, Günther Deuschl","doi":"10.1002/mds.70491","DOIUrl":"https://doi.org/10.1002/mds.70491","url":null,"abstract":"Background Parkinson's disease (PD) is the second most common neurodegenerative disease. It imposes substantial and growing burden on patients, families, and caregivers and reduces quality of life. The disability and care needs associated with PD carry economic ramifications. Objective The objective of the study was to estimate the socioeconomic costs of PD across 47 European countries in 2019. Methods Estimation is based on four steps: (1) determination of prevalence, (2) systematic review of costs, (3) data preparation and imputation, and (4) expert validation. Prevalence data were obtained from the Global Burden of Disease 2021 study (reference year: 2019). Direct, indirect, and informal care costs were analyzed. For countries lacking primary data, an imputation method was employed on the basis of gross national income categories and country‐specific economic indicators. Results Fourteen cost‐of‐illness studies met the inclusion criteria, with all but one being conducted in high‐income countries and no eligible data being available for lower‐middle‐income countries, which precluded cost estimation for these regions. The estimated total costs are €22.8 billion (2019, purchasing power parities [PPP]‐adjusted), of which €17.3 billion (76%) are direct costs, €1 billion (5%) are indirect costs, and €4.4 billion (19%) are informal care costs. The mean cost per patient was €14,278 (median: €8393). Conclusions The increasing economic burden of PD reflects its increasing prevalence, posing significant challenges for health care systems. Our findings emphasize the need for disease‐modifying therapies and preventive strategies. Considerable knowledge gaps remain in the cost‐of‐illness literature, particularly in lower‐middle‐income regions. The results provide evidence to inform political and health economic decision‐making. © 2026 The Author(s). <jats:italic>Movement Disorders</jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"35 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148836235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"August Infographic","authors":"","doi":"10.1002/mds.70478","DOIUrl":"https://doi.org/10.1002/mds.70478","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 Distinct Brain Drivers and Shared Cerebello–Cortical Input in <i>ADCY5</i> and <i>SGCE</i> Hyperkinetic Movements\u0000 </p>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 8","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stimulation and Medication Effects on Subthalamic Nucleus Beta-Band Power in Parkinson's Disease: Implications for Adaptive Deep Brain Stimulation","authors":"Lauren H. Hammer MD, PhD,&nbsp;Stephanie Cernera PhD,&nbsp;Carina R. Oehrn MD, PhD,&nbsp;Jiaang Yao MS,&nbsp;Maria Shcherbakova BS,&nbsp;Amelia G. Hahn BA,&nbsp;Simon Little MBBS, PhD,&nbsp;Philip A. Starr MD, PhD","doi":"10.1002/mds.70261","DOIUrl":"10.1002/mds.70261","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adaptive deep brain stimulation (aDBS) using subthalamic nucleus (STN) beta-band oscillations as a biomarker for the akinetic-rigid symptoms of Parkinson's disease has been proposed to improve the efficacy of stimulation and decrease adverse effects. However, most studies validating STN beta oscillations as a biomarker used perioperative, <i>off</i> medication, and OFF stimulation conditions, limiting their potential relevance to real-world aDBS deployment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We evaluated how stimulation and dopaminergic medication affect beta-range STN oscillatory activity and its ability to predict the hypokinetic parkinsonian state.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In six patients with Parkinson's disease who experienced residual levodopa-related motor fluctuations despite standard-of-care DBS, we studied medication cycle-induced fluctuations of peak STN beta oscillation power during active DBS. We evaluated the magnitude of beta oscillation fluctuations, the frequency of peak beta activity, and the ability to predict the <i>off</i> medication state. Neural signals were collected in the clinic during a medication challenge and at home during naturalistic medication cycles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Medication-induced beta oscillation fluctuations were smaller in the presence of therapeutic DBS compared with when the stimulator was off (<i>P</i> = 0.008). Therapeutic stimulation also decreased the frequency of peak beta activity (<i>P &lt;</i> 0.001). As a result, the beta frequencies with the highest power in the OFF stimulation/<i>off</i> medication state were less accurate than other beta-range bands at predicting the patient's <i>off</i> medication state during active stimulation (<i>P</i> = 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The spectral characteristics of STN beta oscillations and their performance as a biomarker in aDBS for Parkinson's disease are influenced by the stimulation and medication conditions in which it is implemented. © 2026 International Parkinson and Movement Disorder Society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 8","pages":"2022-2032"},"PeriodicalIF":7.7,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147383289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting the Association Between Calcium Channel Blockers and Parkinson's Disease in the E3N Cohort","authors":"Emilie Moutard MPH,&nbsp;Agnès Fournier PhD,&nbsp;Émeline Courtois PhD,&nbsp;Fanny Artaud PhD,&nbsp;Pascale Tubert-Bitter PhD,&nbsp;Emmanuel Roze MD, PhD,&nbsp;Ismaïl Ahmed PhD,&nbsp;Anne C.M. Thiébaut PhD,&nbsp;Alexis Elbaz MD, PhD,&nbsp;Thi Thu Ha Nguyen PharmD, PhD","doi":"10.1002/mds.70336","DOIUrl":"10.1002/mds.70336","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies on calcium channel blockers (CCBs) and Parkinson's disease (PD) risk reached conflicting conclusions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We examined the relationship between CCBs and PD in the E3N cohort of French women followed for 15 years (2004–2018), while taking into account the potential for reverse causation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>New users of CCBs were identified using drug reimbursement databases. We validated incident PD using several data sources. We described trajectories of CCBs use using mixed logistic models within a nested case–control study. We used Cox proportional hazards models for time-varying variables to estimate the association between CCBs (overall, amlodipine, non-amlodipine dihydropyridines [DiCCBs], non-dihydropyridines [non-DiCCBs]) and PD. Main analyses used a 5-year lag; sensitivity analyses without a lag were performed for comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 82,605 women, 603 developed PD and 13,022 used CCBs. Women who started non-DiCCBs had higher PD risk than never users (hazard ratio [HR] = 1.56; 95% confidence interval [95% CI] = 0.99–2.46; <i>P</i>-trend ≤ 0.02). Among non-DiCCBs, diltiazem was associated with PD (HR = 2.20 [95% CI = 1.19–4.04]). There were no significant associations for CCBs overall, amlodipine, and non-amlodipine DiCCBs. In analyses without a lag, amlodipine (HR = 1.45 [95% CI = 1.13–1.87]) and diltiazem (HR = 1.63 [95% CI = 1.02–2.60]) were associated with PD. Results are consistent with trajectories of CCBs prescriptions in PD patients and controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Overall, CCBs were not associated with PD but women who started using diltiazem had higher PD incidence in lagged analyses. Diltiazem and amlodipine were associated with PD in analyses without a lag. These findings are consistent with case reports of parkinsonism induced by specific CCBs and warrant further studies and surveillance. © 2026 The Author(s). <i>Movement Disorders</i> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 8","pages":"2071-2085"},"PeriodicalIF":7.7,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.70336","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Interference Stimulation Modulates Resting State Functional Connectivity of Motor Circuit in Parkinson's Disease","authors":"Yongxin Xu PhD,&nbsp;Chenhao Yang PhD,&nbsp;Yichao Du MPT,&nbsp;Xiaonan Shen MPT,&nbsp;Tingting Li MPT,&nbsp;Yufeng Zhang PhD,&nbsp;Zijun Lu PhD,&nbsp;Jie Zhuang PhD,&nbsp;Nan Chen PhD, DPT,&nbsp;Yulian Zhu PhD, DPT,&nbsp;Chencheng Zhang MD, PhD,&nbsp;Jiaojiao Lü PhD,&nbsp;Lingyan Huang PhD,&nbsp;Lu Li PhD,&nbsp;Jianqiang Lü PhD,&nbsp;Zhenyu Qian PhD,&nbsp;Zhen Wang PhD,&nbsp;Jian Zhang PhD,&nbsp;Junhong Zhou PhD,&nbsp;Yu Liu PhD","doi":"10.1002/mds.70321","DOIUrl":"10.1002/mds.70321","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transcranial temporal interference stimulation (TIs) targeting the subthalamic nucleus (STN) is a novel noninvasive neuromodulation approach with potential to improve motor symptoms in Parkinson's disease (PD). However, its underlying neuroimaging mechanisms remain unclear. Changes in functional connectivity (FC) of the STN and the cortical-basal ganglia-thalamic-cortical (CBTC) circuit are central to PD pathophysiology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This randomized, double-blind, crossover study aimed to examine the effects of STN-TIs on FCs of the STN and regions in the CBTC circuit in PD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>23 participants with mild-to-moderate PD received a 20-minute session of 130 Hz TIs targeting the STN of the contralateral hemisphere of the patient's severely affected side (or the dominant side in case of bilateral disturbance), and active sham stimulation in randomized order. Resting-state functional magnetic resonance imaging (fMRI) and Part III of Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS-III) were completed before and after stimulation. The STN and regions in the CBTC circuit were defined as regions of interest (ROI) for ROI-to-ROI FC analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to sham stimulation, 130 Hz STN-TIs induced a connectivity-specific effect, including the decreased FCs between the targeted side of STN and putamen (<i>P</i> = 0.004–0.046) and caudate (<i>P</i> &lt; 0.001), and increased FC between the targeted side of STN and M1 (<i>P</i> = 0.002–0.004). No severe side effects were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study provides preliminary but novel evidence for the potential modulatory effect of STN-TIs on resting-state neural activities in the motor circuit. © 2026 The Author(s). <i>Movement Disorders</i> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. © 2026 The Author(s). <i>Movement Disorders</i> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 8","pages":"2042-2050"},"PeriodicalIF":7.7,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.70321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Duration Response to Levodopa in the PPMI-Cohort","authors":"Nils Schnalke MD,&nbsp;Tim Feige,&nbsp;Tom Hähnel MD,&nbsp;Björn Falkenburger MD","doi":"10.1002/mds.70344","DOIUrl":"10.1002/mds.70344","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Treatment of Parkinson's disease (PD) with levodopa results in a sustained reduction of symptoms. Although the plasma half-life of levodopa is short, it elicits a lasting effect, the long-duration levodopa response (LDR). A decrease in LDR as PD progresses has been linked to motor complications, but long-term data on the LDR and its clinical implications remain scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim is to analyze the magnitude and impact of the LDR over time using data from the Parkinson's Disease Progression Marker Initiative (PPMI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>First, therapy-naïve Movement Disorder Society-Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III) scores were predicted using a mixed linear model (MLM) from n = 245 untreated people with PD (PwPD). This model yielded an increase of MDS-UPDRS III scores of 2.65 points per year. Using this model, we then calculated LDR and short-duration response in longitudinal data of 148 initially therapy-naïve PwPD. Symptom progression was analyzed using correlation analyses and MLMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the 98 PwPD with observed LDR, the LDR accounted for approximately half of the total levodopa response. No significant change in LDR magnitude was observed over up to 10 years (analysis of variance, <i>P</i> = 0.14; generalized estimating equations, <i>P</i> = 0.26). The LDR magnitude was not associated with the onset of motor complications. PwPD with absent LDR (n = 50) progressed faster than PwPD with observed LDR in several motor and non-motor domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The LDR is a stable component of the levodopa response and needs to be considered in clinical trials. These findings argue against a declining LDR as a major driver of motor fluctuations in PD. © 2026 The Author(s). <i>Movement Disorders</i> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 8","pages":"2033-2041"},"PeriodicalIF":7.7,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.70344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147864137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Movement Disorders: Volume 41, Number 8, August 2026","authors":"","doi":"10.1002/mds.70460","DOIUrl":"https://doi.org/10.1002/mds.70460","url":null,"abstract":"","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 8","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.70460","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech and Deep Brain Stimulation in Parkinson's Disease, Essential Tremor, and Dystonia: A Systematic Review and Meta-analysis","authors":"Elina Tripoliti PhD,&nbsp;Takashi Tsuboi MD, PhD,&nbsp;Michael T. Barbe MD, PhD,&nbsp;Mario Sousa MD,&nbsp;Julie Barkmeier-Kraemer PhD,&nbsp;Hannah Jergas MD, PhD,&nbsp;Gaia Arno BSc,&nbsp;Nicole Buie BSc,&nbsp;Mikayla Day BSc,&nbsp;Petr Krýže MSc,&nbsp;Jayson R. Nelson BSc,&nbsp;Aaron E.L. Warren PhD,&nbsp;Shervin Rahimpour MD,&nbsp;Jan Rusz PhD,&nbsp;Paul Krack MD, PhD,&nbsp;Kristina Simonyan MD, PhD, DrMed","doi":"10.1002/mds.70322","DOIUrl":"10.1002/mds.70322","url":null,"abstract":"<p>Deep brain stimulation (DBS) effectively treats motor symptoms in movement disorders but often compromises speech through incompletely defined mechanisms. We conducted a PROSPERO-registered systematic review and meta-analysis of publications through August 2024 (CRD42024527738). Among 2726 screened records, we included 184 studies: 131 in Parkinson's disease (PD), 32 in essential tremor (ET), and 21 in dystonia, assessing perceptual, acoustic, and patient-reported speech outcomes. Meta-analyses showed that subthalamic nucleus DBS in PD resulted in poorer speech intelligibility compared with best medical treatment (effect size −0.24; 95% confidence interval: −0.46 to −0.03; <i>P</i> = 0.027), with state-dependent decline under active stimulation on longitudinal analysis (Unified Parkinson's Disease Rating Scale Part III item 18 monthly change: medication <i>on</i> +0.016, <i>P</i> &lt; 0.001; medication <i>off</i> +0.002, <i>P</i> = 0.50). In ET, DBS consistently suppressed vocal tremor but increased the risk of dysarthria, particularly with bilateral stimulation. Dystonia outcomes showed greater heterogeneity. Across disorders, sustained phonation measures improved, whereas connected speech performance worsened, indicating selective vulnerability of complex motor tasks. Neuroanatomical mapping identified two nonexclusive mechanisms: current spread to corticobulbar fibers producing spastic speech features and to the cerebellothalamocortical pathway producing ataxic features. Hypokinetic and stuttering-like phenotypes also occurred but likely reflect network-level interactions rather than tract-specific spread. These tract-mediated and network-level alterations appear to interact with hemispheric lateralization, medication state, and longer-term plasticity to produce complex clinical phenotypes. We outline a clinical framework integrating systematic screening, phenotype identification, and targeted programming adjustments. Enhanced speech assessment, precise field mapping, and adaptive DBS paradigms may promote individualized care that optimizes speech and motor function in precision DBS therapy. © 2026 The Author(s). <i>Movement Disorders</i> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p>","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"41 8","pages":"1928-1978"},"PeriodicalIF":7.7,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/mds.70322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}