ArticleMovement disorders : official journal of the Movement Disorder Society2026
Patient-Reported Feedback Suggests an Alternative Sweet Spot for Deep Brain Stimulation Programming in Essential Tremor.
Article in Movement disorders : official journal of the Movement Disorder Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Patient-Reported Feedback in Essential Tremor Deep Brain Stimulation: Distinguishing Perceived Comfort from Tremor Suppression.Movement disorders : official journal of the Movement Disorder Society · 2026Article
- Reply to: Patient-Reported Feedback in Essential Tremor Deep Brain Stimulation: Distinguishing Perceived Comfort from Tremor Suppression.Movement disorders : official journal of the Movement Disorder Society · 2026Article
- Adaptive Deep Brain Stimulation for Parkinson's Disease: Navigating the Roadblocks to Clinical Implementation.Movement disorders : official journal of the Movement Disorder Society · 2026Review
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10 authors.
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Abstract
backgroundDeep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) and caudal zona incerta is an established therapy for essential tremor (ET). Clinical outcomes depend on precise electrode placement and optimal stimulation parameters. Effective programming must balance tremor suppression with side-effect risk, yet systematic incorporation of patient-reported feedback remains limited.
objectiveThe aim was to assess whether subjective patient feedback, quantified via a Visual Analogue Scale (VAS), can guide DBS programming for effective tremor control.
methodsIn 15 VIM-DBS patients, 1253 unique stimulation settings were collected, each rated using a VAS reflecting perceived clinical benefit. Associated volumes of tissue activated were mapped and analyzed. VAS-optimized settings were compared to standard-of-care (SoC) programming. Voxel-wise permutation statistics identified stimulation sweet and sour spots, whereas structural and functional connectivity analyses determined neural correlates of subjective benefit.
resultsVAS-optimized stimulation achieved tremor suppression comparable to SoC settings but with lower energy consumption. Sweet spots correlated with high VAS ratings localized to the dorsal VIM, whereas sour spots were ventral. Connectivity between sweet spots and prefrontal, frontal, and insular regions positively correlated with perceived benefit.
conclusionsIntegrating patient-reported feedback offers a structured, individualized approach to DBS optimization in ET. VAS-guided programming identifies patient-specific sweet spots and delineates connectivity profiles associated with clinical benefit. Particularly, VAS-derived sweet spots were more dorsal than previously suggested targets, highlighting the importance of incorporating subjective feedback to refine optimal stimulation regions. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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