{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T02:33:02Z","timestamp":1780108382684,"version":"3.54.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T00:00:00Z","timestamp":1456790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The reasons underlying the loss of efficacy of deep brain stimulation (<jats:styled-content style=\"fixed-case\">DBS<\/jats:styled-content>) of the thalamic nucleus ventralis intermedius (<jats:styled-content style=\"fixed-case\">VIM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DBS<\/jats:styled-content>) over time in patients with essential tremor are not well understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Long\u2010term clinical outcome and stimulation parameters were evaluated in 14 patients with essential tremor who underwent <jats:styled-content style=\"fixed-case\">VIM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DBS<\/jats:styled-content>. The mean \u00b1 standard deviation postoperative follow\u2010up was 7.7 \u00b1 3.8 years. At each visit (every 3\u20136 months), tremor was assessed using the Fahn\u2010Tolosa\u2010Marin tremor rating scale (<jats:styled-content style=\"fixed-case\">FTM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">TRS<\/jats:styled-content>) and stimulation parameters were recorded (contacts, voltage, frequency, pulse width, and total electrical energy delivered by the internal generator [<jats:styled-content style=\"fixed-case\">TEED<\/jats:styled-content><jats:sub>1sec<\/jats:sub>]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean reduction in <jats:styled-content style=\"fixed-case\">FTM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">TRS<\/jats:styled-content> score was 73.4% at 6 months after <jats:styled-content style=\"fixed-case\">VIM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DBS<\/jats:styled-content> surgery (<jats:italic>P<\/jats:italic> &lt; 0.001) and 50.1% at the last visit (<jats:italic>P<\/jats:italic> &lt; 0.001). The gradual worsening of <jats:styled-content style=\"fixed-case\">FTM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">TRS<\/jats:styled-content> scores over time fit a linear regression model (coefficient of determination [R<jats:sup>2<\/jats:sup>] = 0.887; <jats:italic>P<\/jats:italic> &lt; 0.001). Stimulation adjustments to optimize tremor control required a statistically significant increase in voltage (<jats:italic>P<\/jats:italic> = 0.01), pulse width (<jats:italic>P<\/jats:italic> = 0.01), frequency (<jats:italic>P<\/jats:italic> = 0.02), and <jats:styled-content style=\"fixed-case\">TEED<\/jats:styled-content><jats:sub>1sec<\/jats:sub> (<jats:italic>P<\/jats:italic> = 0.008). <jats:styled-content style=\"fixed-case\">TEED<\/jats:styled-content><jats:sub>1sec<\/jats:sub> fit a third\u2010order polynomial curve model throughout the follow\u2010up period (R<jats:sup>2<\/jats:sup> = 0.966; <jats:italic>P<\/jats:italic> &lt; 0.001). The initial exponential increase (first 4 years of <jats:styled-content style=\"fixed-case\">VIM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DBS<\/jats:styled-content>) was followed by a plateau and a further increase from the seventh year onward.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The current findings suggest that the waning effect of <jats:styled-content style=\"fixed-case\">VIM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DBS<\/jats:styled-content> over time in patients with essential tremor may be the consequence of a combination of factors. Superimposed on the progression of the disease, tolerance can occur during the early years of stimulation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.12337","type":"journal-article","created":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T08:52:02Z","timestamp":1456822322000},"page":"567-572","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Long\u2010term Thalamic Deep Brain Stimulation for Essential Tremor: Clinical Outcome and Stimulation Parameters"],"prefix":"10.1002","volume":"3","author":[{"given":"Pedro M.","family":"Rodr\u00edguez Cruz","sequence":"first","affiliation":[{"name":"Movement Disorders Deep Brain Stimulation Group Hospital General Universitario Gregorio Mara\u00f1\u00f3n Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Vargas","sequence":"additional","affiliation":[{"name":"Movement Disorders Deep Brain Stimulation Group Hospital General 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