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Tolerance and disease progression are considered to be the two main reasons underlying the loss of long\u2010term efficacy of Vim\u2010DBS. This study aimed to explore whether Vim\u2010DBS shows long\u2010term loss of efficacy and to evaluate the reasons for this diminished efficacy from different aspects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a repeated\u2010measures meta\u2010analysis of 533 patients from 18\u00a0studies, Vim\u2010DBS efficacy was evaluated at \u22646\u00a0months, 7\u201312\u00a0months, 1\u20133\u00a0years, and \u22654\u00a0years. The primary outcomes were the score changes in different components of the Fahn\u2010Tolosa\u2010Marin Tremor Rating Scale (TRS; total score, motor score, hand\u2010function score, and activities of daily living [ADL] score). Secondary outcomes were the long\u2010term predictive factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The TRS total, motor, and ADL scores showed significant deterioration with disease progression (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.047, and <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001, respectively), while the TRS total (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), hand\u2010function (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.036), and ADL (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.004) scores indicated a significant long\u2010term reduction in DBS efficacy, although the motor subscore indicated no loss of efficacy. Hand\u2010function (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and ADL (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.028) scores indicated DBS tolerance, while the TRS total and motor scores did not. Stimulation frequency and preoperative score were predictive factors for long\u2010term results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides level 3a evidence that long\u2010term Vim\u2010DBS is effective in controlling motor symptoms without waning benefits. The efficacy reduction for hand function was caused by DBS tolerance, while that for ADL was caused by DBS tolerance and disease progression. More attention should be given to actual functional recovery rather than changes in motor scores in patients with ET.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.13770","type":"journal-article","created":{"date-parts":[[2021,12,6]],"date-time":"2021-12-06T05:52:40Z","timestamp":1638769960000},"page":"279-288","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Loss of long\u2010term benefit from VIM\u2010DBS in essential tremor: A\u00a0secondary analysis of repeated measurements"],"prefix":"10.1111","volume":"28","author":[{"given":"Yutong","family":"Bai","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Beijing Tiantan Hospital Capital Medical University  Beijing China"},{"name":"Beijing Key Laboratory of Neurostimulation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixiao","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery 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