{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T04:33:30Z","timestamp":1780806810824,"version":"3.54.1"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T00:00:00Z","timestamp":1651622400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T00:00:00Z","timestamp":1651622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["SFB 936 C8"],"award-info":[{"award-number":["SFB 936 C8"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Universit\u00e4tsklinikum Hamburg-Eppendorf (UKE)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of this study was to assess the effects of novel stimulation algorithms of deep brain stimulation (short pulse and directional stimulation) in the ventrointermediate thalamus and posterior subthalamic area (VIM\/PSA-DBS) on tremor in Parkinson\u2019s disease (PD) and to compare the effects with those in essential tremor (ET). We recruited six PD patients (70.8\u2009\u00b1\u200910.4\u00a0years) and seven ET patients (64.4\u2009\u00b1\u20099.9\u00a0years) with implanted VIM\/PSA-DBS in a stable treatment condition (&gt;\u20093\u00a0months postoperatively). Tremor severity and ataxia were assessed in four different stimulation conditions in a randomized order: DBS switched off (STIM OFF), omnidirectional stimulation with 60\u00a0\u00b5s (oDBS60), omnidirectional stimulation with 30\u00a0\u00b5s (oDBS30), directional stimulation at the best segment with 60\u00a0\u00b5s (dDBS60). In both patient groups, all three DBS stimulation modes reduced the total tremor score compared to STIM OFF, whereas stimulation-induced ataxia was reduced by oDBS30 and partially by dDBS60 compared to oDBS60. Tremor reduction was more pronounced in PD than in ET due to a limited DBS effect on intention and action-specific drawing tremor in ET. In PD and ET tremor, short pulse or directional VIM\/PSA-DBS is an effective and well tolerated therapeutic option.<\/jats:p><jats:p><jats:bold>Trial registration: <\/jats:bold>The study was registered in the DRKS (ID DRKS00025329, 18.05.2021, German Clinical Trials Register, DRKS\u2014Deutsches Register Klinischer Studien).<\/jats:p>","DOI":"10.1038\/s41598-022-11291-9","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T09:02:39Z","timestamp":1651654959000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Short pulse and directional thalamic deep brain stimulation have differential effects in parkinsonian and essential tremor"],"prefix":"10.1038","volume":"12","clinical-trial-number":[{"clinical-trial-number":"drks00025329","registry":"10.18810\/drks"}],"author":[{"given":"Ute","family":"Hidding","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Schaper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Gulberti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Buhmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Gerloff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian K. E.","family":"Moll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Hamel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-un","family":"Choe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"P\u00f6tter-Nerger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,5,4]]},"reference":[{"key":"11291_CR1","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1002\/mds.22838","volume":"25","author":"ED Louis","year":"2010","unstructured":"Louis, E. D. & Ferreira, J. J. How common is the most common adult movement disorder? Update on the worldwide prevalence of essential tremor. Mov. Disord. 25, 534\u2013541. https:\/\/doi.org\/10.1002\/mds.22838 (2010).","journal-title":"Mov. Disord."},{"key":"11291_CR2","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s40035-017-0086-4","volume":"6","author":"W Chen","year":"2017","unstructured":"Chen, W., Hopfner, F., Becktepe, J. S. & Deuschl, G. Rest tremor revisited: Parkinson\u2019s disease and other disorders. Transl. Neurodegener. 6, 16. https:\/\/doi.org\/10.1186\/s40035-017-0086-4 (2017).","journal-title":"Transl. Neurodegener."},{"key":"11291_CR3","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1002\/mds.27121","volume":"33","author":"KP Bhatia","year":"2018","unstructured":"Bhatia, K. P. et al. Consensus Statement on the classification of tremors. From the task force on tremor of the International Parkinson and Movement Disorder Society. Mov. Disord. 33, 75\u201387. https:\/\/doi.org\/10.1002\/mds.27121 (2018).","journal-title":"Mov. Disord."},{"key":"11291_CR4","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1136\/jnnp.66.3.289","volume":"66","author":"P Limousin","year":"1999","unstructured":"Limousin, P., Speelman, J. D., Gielen, F. & Janssens, M. Multicentre European study of thalamic stimulation in parkinsonian and essential tremor. J. Neurol. Neurosurg. Psychiatry 66, 289\u2013296 (1999).","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"11291_CR5","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000005956","author":"MT Barbe","year":"2018","unstructured":"Barbe, M. T. et al. DBS of the PSA and the VIM in essential tremor: A randomized, double-blind, crossover trial. Neurology https:\/\/doi.org\/10.1212\/WNL.0000000000005956 (2018).","journal-title":"Neurology"},{"key":"11291_CR6","doi-asserted-by":"publisher","first-page":"1416","DOI":"10.1212\/WNL.0000000000004295","volume":"89","author":"RG Cury","year":"2017","unstructured":"Cury, R. G. et al. Thalamic deep brain stimulation for tremor in Parkinson disease, essential tremor, and dystonia. Neurology 89, 1416\u20131423. https:\/\/doi.org\/10.1212\/WNL.0000000000004295 (2017).","journal-title":"Neurology"},{"key":"11291_CR7","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1136\/jnnp.74.10.1362","volume":"74","author":"JP Dick","year":"2003","unstructured":"Dick, J. P. Multicentre European study of thalamic stimulation in essential tremor. J. Neurol. Neurosurg. Psychiatry 74, 1362\u20131363 (2003).","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"11291_CR8","doi-asserted-by":"publisher","first-page":"1608","DOI":"10.1093\/brain\/awm077","volume":"130","author":"J Herzog","year":"2007","unstructured":"Herzog, J. et al. Kinematic analysis of thalamic versus subthalamic neurostimulation in postural and intention tremor. Brain 130, 1608\u20131625. https:\/\/doi.org\/10.1093\/brain\/awm077 (2007).","journal-title":"Brain"},{"key":"11291_CR9","doi-asserted-by":"publisher","DOI":"10.1111\/ner.13234","author":"S Bruno","year":"2020","unstructured":"Bruno, S. et al. Directional deep brain stimulation of the thalamic ventral intermediate area for essential tremor increases therapeutic window. Neuromodulation https:\/\/doi.org\/10.1111\/ner.13234 (2020).","journal-title":"Neuromodulation"},{"key":"11291_CR10","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000006033","author":"CU Choe","year":"2018","unstructured":"Choe, C. U. et al. Thalamic short pulse stimulation diminishes adverse effects in essential tremor patients. Neurology https:\/\/doi.org\/10.1212\/WNL.0000000000006033 (2018).","journal-title":"Neurology"},{"key":"11291_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2018.04.019","author":"AS Moldovan","year":"2018","unstructured":"Moldovan, A. S. et al. Less is more\u2014Pulse width dependent therapeutic window in deep brain stimulation for essential tremor. Brain Stimul. https:\/\/doi.org\/10.1016\/j.brs.2018.04.019 (2018).","journal-title":"Brain Stimul."},{"key":"11291_CR12","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2017.12.015","author":"P Rebelo","year":"2018","unstructured":"Rebelo, P. et al. Thalamic directional deep brain stimulation for tremor: Spend less, get more. Brain Stimul. https:\/\/doi.org\/10.1016\/j.brs.2017.12.015 (2018).","journal-title":"Brain Stimul."},{"key":"11291_CR13","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1002\/acn3.168","volume":"2","author":"MM Reich","year":"2015","unstructured":"Reich, M. M. et al. Short pulse width widens the therapeutic window of subthalamic neurostimulation. Ann. Clin. Transl. Neurol. 2, 427\u2013432. https:\/\/doi.org\/10.1002\/acn3.168 (2015).","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"11291_CR14","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1002\/mds.27238","volume":"33","author":"F Steigerwald","year":"2018","unstructured":"Steigerwald, F. et al. Pulse duration settings in subthalamic stimulation for Parkinson\u2019s disease. Mov. Disord. 33, 165\u2013169. https:\/\/doi.org\/10.1002\/mds.27238 (2018).","journal-title":"Mov. Disord."},{"key":"11291_CR15","doi-asserted-by":"publisher","first-page":"3144","DOI":"10.1093\/brain\/awz261","volume":"142","author":"MF Dirkx","year":"2019","unstructured":"Dirkx, M. F. et al. Cerebral differences between dopamine-resistant and dopamine-responsive Parkinson\u2019s tremor. Brain 142, 3144\u20133157. https:\/\/doi.org\/10.1093\/brain\/awz261 (2019).","journal-title":"Brain"},{"issue":"Suppl 1","key":"11291_CR16","doi-asserted-by":"publisher","first-page":"S118","DOI":"10.1016\/S1353-8020(13)70029-4","volume":"20","author":"M Hallett","year":"2014","unstructured":"Hallett, M. Tremor: Pathophysiology. Parkinsonism Relat. Disord. 20(Suppl 1), S118-122. https:\/\/doi.org\/10.1016\/S1353-8020(13)70029-4 (2014).","journal-title":"Parkinsonism Relat. Disord."},{"key":"11291_CR17","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0178984","volume":"12","author":"C Buhmann","year":"2017","unstructured":"Buhmann, C. et al. Adverse events in deep brain stimulation: A retrospective long-term analysis of neurological, psychiatric and other occurrences. PLoS ONE 12, e0178984. https:\/\/doi.org\/10.1371\/journal.pone.0178984 (2017).","journal-title":"PLoS ONE"},{"key":"11291_CR18","doi-asserted-by":"publisher","first-page":"2515","DOI":"10.1152\/jn.90574.2008","volume":"100","author":"F Steigerwald","year":"2008","unstructured":"Steigerwald, F. et al. Neuronal activity of the human subthalamic nucleus in the Parkinsonian and nonparkinsonian state. J. Neurophysiol. 100, 2515\u20132524. https:\/\/doi.org\/10.1152\/jn.90574.2008 (2008).","journal-title":"J. Neurophysiol."},{"key":"11291_CR19","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.parkreldis.2019.03.028","volume":"64","author":"U Hidding","year":"2019","unstructured":"Hidding, U. et al. Mapping stimulation-induced beneficial and adverse effects in the subthalamic area of essential tremor patients. Parkinsonism Relat. Disord. 64, 150\u2013155. https:\/\/doi.org\/10.1016\/j.parkreldis.2019.03.028 (2019).","journal-title":"Parkinsonism Relat. Disord."},{"key":"11291_CR20","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1002\/ana.20525","volume":"58","author":"AM Koss","year":"2005","unstructured":"Koss, A. M., Alterman, R. L., Tagliati, M. & Shils, J. L. Calculating total electrical energy delivered by deep brain stimulation systems. Ann. Neurol. 58, 168. https:\/\/doi.org\/10.1002\/ana.20525 (2005) (author reply 168\u2013169).","journal-title":"Ann. Neurol."},{"key":"11291_CR21","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-323656","author":"F Lin","year":"2021","unstructured":"Lin, F. et al. Comparison of efficacy of deep brain stimulation and focused ultrasound in parkinsonian tremor: A systematic review and network meta-analysis. J. Neurol. Neurosurg. Psychiatry. https:\/\/doi.org\/10.1136\/jnnp-2020-323656 (2021).","journal-title":"J. Neurol. Neurosurg. Psychiatry."},{"key":"11291_CR22","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/S1474-4422(10)70322-7","volume":"10","author":"G Deuschl","year":"2011","unstructured":"Deuschl, G., Raethjen, J., Hellriegel, H. & Elble, R. Treatment of patients with essential tremor. Lancet Neurol. 10, 148\u2013161. https:\/\/doi.org\/10.1016\/S1474-4422(10)70322-7 (2011).","journal-title":"Lancet Neurol."},{"key":"11291_CR23","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1093\/brain\/awt304","volume":"137","author":"S Groppa","year":"2014","unstructured":"Groppa, S. et al. Physiological and anatomical decomposition of subthalamic neurostimulation effects in essential tremor. Brain 137, 109\u2013121. https:\/\/doi.org\/10.1093\/brain\/awt304 (2014).","journal-title":"Brain"},{"key":"11291_CR24","doi-asserted-by":"publisher","first-page":"2948","DOI":"10.1093\/brain\/aww223","volume":"139","author":"MM Reich","year":"2016","unstructured":"Reich, M. M. et al. Progressive gait ataxia following deep brain stimulation for essential tremor: Adverse effect or lack of efficacy?. Brain 139, 2948\u20132956. https:\/\/doi.org\/10.1093\/brain\/aww223 (2016).","journal-title":"Brain"},{"key":"11291_CR25","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1136\/jnnp-2018-319427","volume":"90","author":"D Kroneberg","year":"2019","unstructured":"Kroneberg, D., Ewert, S., Meyer, A. C. & Kuhn, A. A. Shorter pulse width reduces gait disturbances following deep brain stimulation for essential tremor. J. Neurol. Neurosurg. Psychiatry 90, 1046\u20131050. https:\/\/doi.org\/10.1136\/jnnp-2018-319427 (2019).","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"11291_CR26","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1159\/000511716","volume":"99","author":"T Wirth","year":"2021","unstructured":"Wirth, T. et al. Endurance of short pulse width thalamic stimulation efficacy in intention tremor. Stereotact. Funct. Neurosurg. 99, 281\u2013286. https:\/\/doi.org\/10.1159\/000511716 (2021).","journal-title":"Stereotact. Funct. Neurosurg."},{"key":"11291_CR27","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1002\/mds.27265","volume":"33","author":"W Bouthour","year":"2018","unstructured":"Bouthour, W. et al. Short pulse width in subthalamic stimulation in Parkinson\u2019s disease: A randomized, double-blind study. Mov. Disord. 33, 169\u2013173. https:\/\/doi.org\/10.1002\/mds.27265 (2018).","journal-title":"Mov. Disord."},{"key":"11291_CR28","doi-asserted-by":"publisher","first-page":"235","DOI":"10.3233\/JPD-171077","volume":"7","author":"V Dayal","year":"2017","unstructured":"Dayal, V., Limousin, P. & Foltynie, T. Subthalamic nucleus deep brain stimulation in Parkinson\u2019s disease: The effect of varying stimulation parameters. J. Parkinsons. Dis. 7, 235\u2013245. https:\/\/doi.org\/10.3233\/JPD-171077 (2017).","journal-title":"J. Parkinsons. Dis."},{"key":"11291_CR29","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1016\/j.brs.2020.03.017","volume":"13","author":"CJ Anderson","year":"2020","unstructured":"Anderson, C. J., Anderson, D. N., Pulst, S. M., Butson, C. R. & Dorval, A. D. Neural selectivity, efficiency, and dose equivalence in deep brain stimulation through pulse width tuning and segmented electrodes. Brain Stimul. 13, 1040\u20131050. https:\/\/doi.org\/10.1016\/j.brs.2020.03.017 (2020).","journal-title":"Brain Stimul."},{"key":"11291_CR30","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1212\/WNL.0000000000000823","volume":"83","author":"MF Contarino","year":"2014","unstructured":"Contarino, M. F. et al. Directional steering: A novel approach to deep brain stimulation. Neurology 83, 1163\u20131169. https:\/\/doi.org\/10.1212\/WNL.0000000000000823 (2014).","journal-title":"Neurology"},{"key":"11291_CR31","doi-asserted-by":"publisher","first-page":"2015","DOI":"10.1093\/brain\/awu102","volume":"137","author":"C Pollo","year":"2014","unstructured":"Pollo, C. et al. Directional deep brain stimulation: An intraoperative double-blind pilot study. Brain 137, 2015\u20132026. https:\/\/doi.org\/10.1093\/brain\/awu102 (2014).","journal-title":"Brain"},{"key":"11291_CR32","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1002\/mds.26669","volume":"31","author":"F Steigerwald","year":"2016","unstructured":"Steigerwald, F., Muller, L., Johannes, S., Matthies, C. & Volkmann, J. Directional deep brain stimulation of the subthalamic nucleus: A pilot study using a novel neurostimulation device. Mov. Disord. 31, 1240\u20131243. https:\/\/doi.org\/10.1002\/mds.26669 (2016).","journal-title":"Mov. Disord."},{"key":"11291_CR33","doi-asserted-by":"publisher","first-page":"1380","DOI":"10.1002\/mds.27093","volume":"32","author":"TA Dembek","year":"2017","unstructured":"Dembek, T. A. et al. Directional DBS increases side-effect thresholds\u2014A prospective, double-blind trial. Mov. Disord. 32, 1380\u20131388. https:\/\/doi.org\/10.1002\/mds.27093 (2017).","journal-title":"Mov. Disord."},{"key":"11291_CR34","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1016\/j.brs.2017.12.015","volume":"11","author":"P Rebelo","year":"2018","unstructured":"Rebelo, P. et al. Thalamic directional deep brain stimulation for tremor: Spend less, get more. Brain Stimul. 11, 600\u2013606. https:\/\/doi.org\/10.1016\/j.brs.2017.12.015 (2018).","journal-title":"Brain Stimul."},{"key":"11291_CR35","doi-asserted-by":"publisher","DOI":"10.1111\/ner.13407","author":"A Schnitzler","year":"2021","unstructured":"Schnitzler, A. et al. Directional deep brain stimulation for Parkinson\u2019s disease: Results of an international crossover study with randomized, double-blind primary endpoint. Neuromodulation https:\/\/doi.org\/10.1111\/ner.13407 (2021).","journal-title":"Neuromodulation"},{"key":"11291_CR36","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1002\/ana.22361","volume":"69","author":"RC Helmich","year":"2011","unstructured":"Helmich, R. C., Janssen, M. J., Oyen, W. J., Bloem, B. R. & Toni, I. Pallidal dysfunction drives a cerebellothalamic circuit into Parkinson tremor. Ann. Neurol. 69, 269\u2013281. https:\/\/doi.org\/10.1002\/ana.22361 (2011).","journal-title":"Ann. Neurol."},{"key":"11291_CR37","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1016\/j.neuroimage.2010.09.028","volume":"54","author":"H Mure","year":"2011","unstructured":"Mure, H. et al. Parkinson\u2019s disease tremor-related metabolic network: Characterization, progression, and treatment effects. Neuroimage 54, 1244\u20131253. https:\/\/doi.org\/10.1016\/j.neuroimage.2010.09.028 (2011).","journal-title":"Neuroimage"},{"key":"11291_CR38","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s40673-020-00121-1","volume":"7","author":"ED Louis","year":"2020","unstructured":"Louis, E. D. & Faust, P. L. Essential tremor: The most common form of cerebellar degeneration?. Cerebellum Ataxias 7, 12. https:\/\/doi.org\/10.1186\/s40673-020-00121-1 (2020).","journal-title":"Cerebellum Ataxias"},{"key":"11291_CR39","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1038\/s41582-019-0302-1","volume":"16","author":"ED Louis","year":"2020","unstructured":"Louis, E. D. & Faust, P. L. Essential tremor pathology: Neurodegeneration and reorganization of neuronal connections. Nat. Rev. Neurol. 16, 69\u201383. https:\/\/doi.org\/10.1038\/s41582-019-0302-1 (2020).","journal-title":"Nat. Rev. Neurol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-11291-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-11291-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-11291-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T02:36:15Z","timestamp":1669343775000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-11291-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,4]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["11291"],"URL":"https:\/\/doi.org\/10.1038\/s41598-022-11291-9","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,4]]},"assertion":[{"value":"1 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 April 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"CB has received speaking fees from Abbvie, Bial, TAD Pharma, UCB Pharma and Zambon and travel expenses from Medtronic. CG received fees as a consultant or lecture fees from Bayer Vital, Boehringer Ingelheim, EBS technologies, GlaxoSmithKline, Lundbeck, Pfizer, Sanofi Aventis, Silk Road Medical and UCB. CM has received fees for teaching, lectures and consultations from Abbott, lecture fees from Inomed and fees from Brainlab for software testing. WH has received honoraria for lectures, participation in advisory boards and travel expenses from Abbott, Boston Scientific and Medtronic. MP has received honoraria for lectures, participation in advisory boards and travel expenses from Boston Scientific, Abbott, Medtronic, Licher MT and Abbvie. UH, MS, AG and CC declare no commercial or financial relationships that could be construed as a potential conflict of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"7251"}}