{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:10:53Z","timestamp":1792811453242,"version":"4.5.0"},"reference-count":39,"publisher":"BMJ","issue":"7","funder":[{"name":"University Hospital of Northern Sweden and Ume\u00e5 University, Ume\u00e5","id":[{"id":"https:\/\/ror.org\/05kb8h459","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Several open-label studies have shown good effect of deep brain stimulation (DBS) in the caudal zona incerta (cZi) on tremor, including parkinsonian tremor, and in some cases also a benefit on akinesia and axial symptoms. The aim of this study was to evaluate objectively the effect of cZi DBS in patients with Parkinson\u2019s disease (PD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>25 patients with PD were randomised to either cZi DBS or best medical treatment. The primary outcomes were differences between the groups in the motor scores of the Unified Parkinson\u2019s Disease Rating Scale (UPDRS-III) rated single-blindly at 6\u2009months and differences in the Parkinson\u2019s Disease Questionnaire 39 items (PDQ-39). 19 patients, 10 in the medical arm and 9 in the DBS arm, fulfilled the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The DBS group had 41% better UPDRS-III scores off-medication on-stimulation compared with baseline, whereas the scores of the non-surgical patients off-medication were unchanged. In the on-medication condition, there were no differences between the groups, neither at baseline nor at 6\u2009months. Subitems of the UPDRS-III showed a robust effect of cZi DBS on tremor. The PDQ-39 domains \u2018stigma\u2019 and \u2018ADL\u2019 improved only in the DBS group. The PDQ-39 summary index improved in both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This is the first randomised blinded evaluation of cZi DBS showing its efficacy on PD symptoms. The most striking effect was on tremor; however, the doses of dopaminergic medications could not be decreased. cZi DBS in PD may be an addition to existing established targets, enabling tailoring the surgery to the needs of the individual patient.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnnp-2017-317219","type":"journal-article","created":{"date-parts":[[2018,1,31]],"date-time":"2018-01-31T12:45:44Z","timestamp":1517402744000},"page":"710-716","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":96,"title":["Deep brain stimulation in the caudal zona incerta versus best medical treatment in patients with Parkinson\u2019s disease: a randomised blinded evaluation"],"prefix":"10.1136","volume":"89","author":[{"given":"Patric","family":"Blomstedt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasmus","family":"Stenmark 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