{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:58:36Z","timestamp":1787612316260,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Deep brain stimulation (DBS) is a common treatment offered for a variety of movement disorders refractory or resistant to medical management. It is important to confirm potential candidates possess a favorable risk\u2013benefit ratio during screening.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the rates and reasons for failure when applying a multidisciplinary DBS candidacy approach for movement disorders including Parkinson's disease (PD), essential tremor (ET), and dystonia.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective chart review was conducted using the University of Florida INFORM database to identify consecutive patients referred for multidisciplinary evaluation of DBS candidacy. Patients who were either tabled (deferred for later consideration) or denied were defined as multidisciplinary evaluation failures (MEF) and further characterized using descriptive statistics to understand factors underpinning the decision not to pursue DBS.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 1758 patients underwent a multidisciplinary review for possible DBS therapy. Of these, 182 (10.4%) were MEF, with 117 (6.7%) denied and 65 (3.7%) tabled. Diagnostic breakdown of MEF included 129 (70.9%) patients with PD, 33 (18.1%) with ET and 18 (9.9%) with dystonia. A total of 13 possible reasons for MEF were identified; the three most common reasons were concern for excessive cognitive risk (62.1%), incongruent expectations for surgery (17.6%) and significant psychiatric concern (16.5%).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Given the broad range of factors that may preclude approval for DBS in movement disorders, a multidisciplinary approach to candidate selection is essential.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mdc3.70699","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:15:38Z","timestamp":1781068538000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Determinants of Deep Brain Stimulation Candidacy Failure in Movement Disorders: A Multidisciplinary Analysis"],"prefix":"10.1002","author":[{"given":"Patricia J.","family":"Graese","sequence":"first","affiliation":[{"name":"Fixel Institute for Neurological Diseases, Department of Neurology University of Florida Gainesville Florida USA"},{"name":"Department of Neurology Virginia Commonwealth University Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hikaru","family":"Kamo","sequence":"additional","affiliation":[{"name":"Fixel Institute for Neurological Diseases, Department of Neurology University of Florida Gainesville Florida USA"},{"name":"Department of Neurology Juntendo University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly D.","family":"Foote","sequence":"additional","affiliation":[{"name":"Fixel Institute for Neurological Diseases, Department of Neurosurgery University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin D.","family":"Hilliard","sequence":"additional","affiliation":[{"name":"Fixel Institute for Neurological Diseases, Department of Neurosurgery University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Bowers","sequence":"additional","affiliation":[{"name":"Department of Clinical and Health Psychology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franchesca","family":"Arias","sequence":"additional","affiliation":[{"name":"Department of Clinical and Health Psychology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitry S.","family":"Davydow","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory M.","family":"Pontone","sequence":"additional","affiliation":[{"name":"Fixel Institute for Neurological Diseases, Department of Neurology University of Florida Gainesville Florida USA"},{"name":"Department of Clinical and Health Psychology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana L.","family":"Ferrara","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn M.","family":"Schiehser","sequence":"additional","affiliation":[{"name":"Department of Clinical and Health Psychology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa R.","family":"Warren","sequence":"additional","affiliation":[{"name":"Fixel Institute for Neurological Diseases, Rehabilitation Center University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole E.","family":"Herndon","sequence":"additional","affiliation":[{"name":"Fixel Institute for Neurological Diseases, Rehabilitation Center University of Florida Gainesville Florida USA"},{"name":"Department of Speech, Language and Hearing Sciences University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison R.","family":"Kraus","sequence":"additional","affiliation":[{"name":"Fixel Institute for Neurological Diseases, Rehabilitation Center University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alana","family":"McKay","sequence":"additional","affiliation":[{"name":"Fixel Institute for Neurological Diseases, Department of Neurology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily J.","family":"Truscott","sequence":"additional","affiliation":[{"name":"Department of Food Science and Human Nutrition Department University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela R.","family":"Zeilman","sequence":"additional","affiliation":[{"name":"Fixel Institute for Neurological Diseases, Department of Neurology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher W.","family":"Hess","sequence":"additional","affiliation":[{"name":"Fixel Institute for Neurological Diseases, Department of Neurology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6247-9358","authenticated-orcid":false,"given":"Michael S.","family":"Okun","sequence":"additional","affiliation":[{"name":"Fixel Institute for Neurological Diseases, Department of Neurology University of Florida Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1001\/jama.2008.929","article-title":"Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial","volume":"301","author":"Weaver FM","year":"2009","journal-title":"JAMA"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000550490","article-title":"Long\u2010term mortality and 10\u2010year outcomes after subthalamic nucleus deep brain stimulation in Parkinson's disease","volume":"9","author":"Kamo H","year":"2026","journal-title":"Stereotact Funct Neurosurg"},{"issue":"11","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1002\/mds.23195","article-title":"Deep brain stimulation for essential tremor: a systematic 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brain stimulation for tremor associated with underlying ataxia syndromes: a case series and discussion of issues","volume":"4","author":"Oyama G","year":"2014","journal-title":"Tremor Other Hyperkinet Mov (N Y)"},{"issue":"12","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1038\/ncpneuro0347","article-title":"Essential tremor: emerging views of a common disorder","volume":"2","author":"Benito\u2010Le\u00f3n J","year":"2006","journal-title":"Nat Clin Pract Neurol"},{"issue":"3","key":"e_1_2_11_30_1","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1002\/mds.22356","article-title":"Gait and balance in essential tremor: variable effects of bilateral thalamic stimulation","volume":"24","author":"Earhart GM","year":"2009","journal-title":"Mov Disord"},{"key":"e_1_2_11_31_1","doi-asserted-by":"crossref","DOI":"10.3389\/fnhum.2024.1353150","article-title":"Management of essential tremor deep brain stimulation\u2010induced side effects","volume":"18","author":"Martinez\u2010Nunez AE","year":"2024","journal-title":"Front Hum Neurosci"},{"issue":"9","key":"e_1_2_11_32_1","doi-asserted-by":"crossref","DOI":"10.3390\/brainsci15090997","article-title":"Positive clinical signs in functional neurological disorders: a narrative review and development of a clinical decision tool","volume":"15","author":"Mavroudis I","year":"2025","journal-title":"Brain Sci"},{"issue":"1","key":"e_1_2_11_33_1","first-page":"S5","article-title":"Inclusion and exclusion criteria for DBS in dystonia","volume":"26","author":"Bronte\u2010Stewart H","year":"2011","journal-title":"Mov Disord"}],"container-title":["Movement Disorders Clinical 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