{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:53:28Z","timestamp":1791568408401,"version":"4.3.4"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T00:00:00Z","timestamp":1647216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006095","name":"Helse S\u00f8r-\u00d8st RHF","doi-asserted-by":"publisher","award":["2015005"],"award-info":[{"award-number":["2015005"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus (VIM) effectively suppresses arm tremor. Uncontrolled studies suggest the posterior subthalamic area (PSA) may be superior. We compared the intra\u2010individual efficacy of VIM\u2010 versus PSA\u2010DBS on tremor suppression and arm function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a randomized, double\u2010blind, crossover trial at Oslo University Hospital in patients (18\u201380\u2009years) with isolated or combined action tremor affecting at least one arm. Four\u2010contact DBS leads were implanted (bi\u2010 or unilaterally) with a trajectory to cover the VIM (upper two contacts) and PSA (lower two contacts). Patients were randomized (1:1 ratio) post\u2010surgery to: Group 1, VIM\u2010stimulation months 0\u20133 (period 1), then PSA\u2010stimulation months 4\u20136 (period 2); Group 2, PSA\u2010stimulation first, then VIM\u2010stimulation. Primary endpoint was the difference in improvement from baseline to the end of the VIM\u2010 versus PSA\u2010period in the sum of the dominant arm tremor scores of the Fahn\u2010Tolosa\u2010Marin Tremor Rating Scale (FTMTRS), items 5\/6\u2009+\u200910\u221214.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010five patients were randomized to Group 1 (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a023) or 2 (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a022). In the primary endpoint per\u2010protocol analysis (mixed model, n\u00a0=\u00a040), mean difference in the sum FTMTRS score improvement for the dominant arm was \u22122.65 points (95% CI \u22124.33 to \u22120.97;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002). The difference in favour of PSA stimulation was highly significant in period 2, but not period 1.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Our randomized trial demonstrated that PSA stimulation provided superior tremor suppression compared with VIM stimulation. A period effect reducing tremor for up to three months in both groups was most likely attributed to a post\u2010surgery stun effect. ANN NEUROL 2022;91:585\u2013601<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.26317","type":"journal-article","created":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T09:03:17Z","timestamp":1644570197000},"page":"585-601","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Deep Brain Stimulation for Arm Tremor: A Randomized Trial Comparing Two Targets"],"prefix":"10.1002","volume":"91","author":[{"given":"Nadja","family":"Kvernmo","sequence":"first","affiliation":[{"name":"Department of Neurology Oslo University Hospital  Oslo Norway"},{"name":"Institute of Clinical Medicine University of Oslo  Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ane E.","family":"Konglund","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin 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