{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:27:18Z","timestamp":1780964838574,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T00:00:00Z","timestamp":1689552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The primary objective of this study was to determine whether two neurosurgical procedures, deep brain stimulation (DBS) and focused ultrasound (FUS), to treat essential tremor (ET) of the upper limb also reduce vocal tremor (VT) in patients with comorbid dysphonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twelve patients with ET and concomitant VT scheduled for neurosurgical intervention (FUS or DBS) or returning for follow\u2010up after DBS implantation were assessed. FUS patients were assessed pre\u2010 and post\u2010intervention and DBS patients were assessed with the electrodes turned on and off post\u2010implantation. Three voice recordings of a sustained \/a\/ were obtained for each participant condition. Percent fundamental frequency variability (FFV) was calculated for each recorded sustained vowel. Additionally, blinded expert perceptual VT rating (VTR) was performed to assess subjective changes in tremors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 12 patients, seven underwent unilateral FUS, and five underwent bilateral DBS. Mean FFV without neurosurgical intervention was 18.3%, SD\u2009=\u20097.8 and with neurosurgical intervention was 6.3%, SD\u2009=\u20093.0 (t (70) =8.7, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Mean FFV decreased in the FUS cohort from 22.0%, SD\u2009=\u20097.1 pre\u2010ablation to 6.7%, SD\u2009=\u20092.4 post\u2010ablation (t (40)\u2009=\u20097.7, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Mean FFV also decreased in the DBS cohort from 15.7%, SD\u2009=\u20097.0 to 6.0%, SD\u2009=\u20093.3 when stimulation was turned on (t (28)=5.7 <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In the FUS group, mean VTR decreased from 4.0 to 1.4 post\u2010ablation (<jats:italic>Z<\/jats:italic>\u2009=\u20097.8, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). In the DBS group, mean VTR decreased from 3.3 to 2.1 with stimulation (<jats:italic>Z<\/jats:italic>\u2009=\u20094.1, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Neurosurgical interventions for ET (bilateral DBS and unilateral FUS) demonstrate acoustic and perceptual benefits for VT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 134:367\u2013373, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30884","type":"journal-article","created":{"date-parts":[[2023,7,17]],"date-time":"2023-07-17T11:38:13Z","timestamp":1689593893000},"page":"367-373","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Voice Improvement After Essential Tremor Treatment via Focused Ultrasound and Deep Brain Stimulation"],"prefix":"10.1002","volume":"134","author":[{"given":"Peter","family":"Larner","sequence":"first","affiliation":[{"name":"School of Medicine University of Virginia  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8188-6899","authenticated-orcid":false,"given":"Rachel","family":"Jonas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery University of Virginia  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3469-6598","authenticated-orcid":false,"given":"Claudia N.","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery University of Virginia  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"McGarey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery University of Virginia  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Lott","sequence":"additional","affiliation":[{"name":"Department of Therapy Services University of Virginia  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayan","family":"Moosa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Virginia  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Jeffrey","family":"Elias","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Virginia  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3693-4617","authenticated-orcid":false,"given":"James","family":"Daniero","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery University of Virginia  Charlottesville Virginia U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22838"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2015.04.019"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27121"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.41.2_part_1.234"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20702"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410350613"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.4137\/JCNSD.S6561"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.35.1.106"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2015.2849"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25485"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.9.1416"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2020.04.021"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.84.2.0203"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410420304"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2018-318240"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600159"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1300962"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-307642"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70048-6"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28716"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200409000-00009"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2011.04.006"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.01.281"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2015.01.156"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2013.01.002"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1044\/2019_JSLHR-S-19-0024"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.50.3.796"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.3171\/2015.3.FOCUS1537"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci6040048"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12739"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2020.09.013"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2012.02.007"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2018.09.029"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000233255.57425.36"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27001"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007134"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.30884","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T12:58:58Z","timestamp":1719925138000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.30884"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,17]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1002\/lary.30884"],"URL":"https:\/\/doi.org\/10.1002\/lary.30884","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,17]]},"assertion":[{"value":"2022-10-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}