{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T04:33:28Z","timestamp":1780806808359,"version":"3.54.1"},"reference-count":22,"publisher":"BMJ","issue":"9","funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["KFO247"],"award-info":[{"award-number":["KFO247"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NeuroCure","award":["Grant to AAK"],"award-info":[{"award-number":["Grant to AAK"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Gait disturbances are frequent side effects occurring during chronic thalamic deep brain stimulation (DBS) in patients with essential tremor (ET). Adapting stimulation settings to shorter pulse widths has been shown to reduce side effects of subthalamic DBS. Here, we assess how a reduction of pulse width changes gait performance of affected patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sensor-based gait assessment was performed to record spatiotemporal gait parameters in 10 healthy subjects (HS) and 7 patients with ET with gait disturbances following thalamic DBS. Patients were tested during standard DBS, after 72 hours of stimulation withdrawal and at least 30 days after adjusting DBS settings to a shorter pulse width of 40 \u00b5s (DBS40PW).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with ET on standard DBS showed significantly higher variability of several spatiotemporal gait parameters compared with HS. Variability of stride length and range of motion of the shanks significantly decreased OFF DBS as compared with standard DBS. This improvement was maintained over 30 days with DBS40PW while providing effective tremor suppression in six out of seven patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Shorter pulse widths may reduce gait disturbances in patients with ET that are induced by DBS while preserving a level of tremor suppression equal to standard stimulation settings.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jnnp-2018-319427","type":"journal-article","created":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T23:04:54Z","timestamp":1550185494000},"page":"1046-1050","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":39,"title":["Shorter pulse width reduces gait disturbances following deep brain stimulation for essential tremor"],"prefix":"10.1136","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5560-538X","authenticated-orcid":false,"given":"Daniel","family":"Kroneberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobhan","family":"Ewert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Christiane","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea A","family":"K\u00fchn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,2,14]]},"reference":[{"key":"2020050722345912000_90.9.1046.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200002173420703"},{"key":"2020050722345912000_90.9.1046.2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2006.104.4.506"},{"key":"2020050722345912000_90.9.1046.3","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/aww223"},{"key":"2020050722345912000_90.9.1046.4","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1007\/s00415-011-5986-0","article-title":"Steady or not following thalamic deep brain stimulation for essential tremor","volume":"258","author":"Hwynn","year":"2011","journal-title":"J Neurol"},{"key":"2020050722345912000_90.9.1046.5","doi-asserted-by":"publisher","DOI":"10.1007\/s12311-009-0111-y"},{"key":"2020050722345912000_90.9.1046.6","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/124.11.2278"},{"key":"2020050722345912000_90.9.1046.7","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awq267"},{"key":"2020050722345912000_90.9.1046.8","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/aws026"},{"key":"2020050722345912000_90.9.1046.9","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awt304"},{"key":"2020050722345912000_90.9.1046.10","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1016\/j.brs.2018.04.019","article-title":"Less is more - Pulse width dependent therapeutic window in deep brain stimulation for essential tremor","volume":"11","author":"Moldovan","year":"2018","journal-title":"Brain Stimul"},{"key":"2020050722345912000_90.9.1046.11","doi-asserted-by":"crossref","first-page":"e704","DOI":"10.1212\/WNL.0000000000006033","article-title":"Thalamic short pulse stimulation diminishes adverse effects in essential tremor patients","volume":"91","author":"Choe","year":"2018","journal-title":"Neurology"},{"key":"2020050722345912000_90.9.1046.12","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1002\/mds.27238","article-title":"Pulse duration settings in subthalamic stimulation for Parkinson's disease","volume":"33","author":"Steigerwald","year":"2018","journal-title":"Mov Disord"},{"key":"2020050722345912000_90.9.1046.13","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1002\/acn3.168","article-title":"Short pulse width widens the therapeutic window of subthalamic neurostimulation","volume":"2","author":"Reich","year":"2015","journal-title":"Ann Clin Transl Neurol"},{"key":"2020050722345912000_90.9.1046.14","doi-asserted-by":"crossref","unstructured":"Reich MM , Pozzi NG , Brumberg J , et al . 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