{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T07:48:46Z","timestamp":1791791326314,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82301664"],"award-info":[{"award-number":["82301664"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82571678"],"award-info":[{"award-number":["82571678"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82471495"],"award-info":[{"award-number":["82471495"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["23YF1424000"],"award-info":[{"award-number":["23YF1424000"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2024M762057"],"award-info":[{"award-number":["2024M762057"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2026,9]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The posterior subthalamic area (PSA) is a familiarized target for Parkinson's disease (PD) in the lesioning era and has recently been reconsidered for deep brain stimulation (DBS).<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The aim of this study was to compare the therapeutic efficacy of PSA versus subthalamic nucleus (STN) DBS in tremor\u2010dominant Parkinson's disease (TD\u2010PD).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This single\u2010center, randomized, crossover trial was conducted at Ruijin Hospital, Shanghai, China, from June 2022 to August 2025. Patients with\n TD<\/jats:styled-content>\n \u2010\n PD<\/jats:styled-content>\n received bilateral\n DBS<\/jats:styled-content>\n implants via a single trajectory targeting both\n PSA<\/jats:styled-content>\n and\n STN<\/jats:styled-content>\n . Participants received 2\u2009months of\n PSA<\/jats:styled-content>\n stimulation followed by 2\u2009months of\n STN<\/jats:styled-content>\n stimulation or vice versa, with blinded programming and evaluation. The primary outcome was the difference in\n off<\/jats:italic>\n medication improvement from baseline to the end of each stimulation period in the tremor subscore of the Movement Disorder Society\u2013sponsored revision of the Unified Parkinson's Disease Rating Scale\n Part III (MDS UPDRS<\/jats:styled-content>\n \u2010\n III<\/jats:styled-content>\n ;\n ClinicalTrials.gov<\/jats:ext-link>\n ,\n NCT05382858<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of the 40 patients assessed for eligibility, 27 were randomly assigned and 19 completed the randomized crossover phase. Both\n PSA<\/jats:styled-content>\n \u2010DBS and\n STN<\/jats:styled-content>\n \u2010\n DBS<\/jats:styled-content>\n significantly reduced the\n MDS UPDRS<\/jats:styled-content>\n \u2010\n III<\/jats:styled-content>\n tremor subscore (baseline, 17.5 [3.3];\n PSA<\/jats:styled-content>\n , 4.5 [2.8];\n STN<\/jats:styled-content>\n , 8.0 [5.3];\n P<\/jats:italic>\n \u2009<\u20090.001 for both).\n PSA<\/jats:styled-content>\n \u2010\n DBS<\/jats:styled-content>\n achieved greater tremor suppression than\n STN<\/jats:styled-content>\n \u2010\n DBS<\/jats:styled-content>\n (adjusted mean difference\u2009\u22123.3; 95% confidence interval [\n CI<\/jats:styled-content>\n ]: \u22125.4 to \u22121.3;\n P<\/jats:italic>\n \u2009=\u20090.004).\n STN<\/jats:styled-content>\n \u2010\n DBS<\/jats:styled-content>\n led to greater balance improvement (adjusted mean difference\u2009\u22121.7; 95%\n CI<\/jats:styled-content>\n : \u22122.6 to \u22120.7;\n P<\/jats:italic>\n \u2009=\u20090.002). Three cases of abnormal impedance occurred. Other adverse effects were mostly stimulation related and could be resolved with reprogramming.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Given the limited sample size and study attrition, these findings should be considered hypothesis generating. Nonetheless, PSA\u2010DBS appears to be a safe and effective alternative or complementary target to STN in treating TD\u2010PD and warrants further investigation in larger, definitive trials. \u00a9 2026 The Author(s).\n Movement Disorders<\/jats:italic>\n published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mds.70363","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T05:47:07Z","timestamp":1779688027000},"page":"2375-2385","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Deep Brain Stimulation of the Posterior Subthalamic Area and the Subthalamic Nucleus in Tremor\u2010Dominant Parkinson's Disease: A Randomized, Crossover Trial"],"prefix":"10.1002","volume":"41","author":[{"given":"Zhengyu","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Center for Functional Neurosurgery Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7683-6873","authenticated-orcid":false,"given":"Zhitong","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Functional Neurosurgery Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixin","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Functional Neurosurgery Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Functional Neurosurgery Ruijin Hospital 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