{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T01:16:30Z","timestamp":1792545390574,"version":"4.5.0"},"reference-count":30,"publisher":"Ubiquity Press, Ltd.","license":[{"start":{"date-parts":[[2024,8,21]],"date-time":"2024-08-21T00:00:00Z","timestamp":1724198400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health: NINDS","doi-asserted-by":"crossref","award":["R01 NS118179"],"award-info":[{"award-number":["R01 NS118179"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TOHM"],"abstract":"<jats:p>Background: Whether low-frequency deep brain stimulation (DBS) in the caudal zona incerta (cZi) can improve cerebellar ataxia symptoms remains unexplored.\nCase Report: We report a 66-year-old man initially diagnosed with essential tremor and subsequently developed cerebellar ataxia after bilateral cZi DBS implantation. We tested the effects of low-frequency DBS stimulations (sham, 10 Hz, 15 Hz, 30 Hz) on ataxia severity.\nDiscussion: Low-frequency cZi DBS improves ataxic speech at 30 Hz, but not at 10 Hz or 15 Hz in this patient. Low-frequency DBS did not improve gait or stance. Therefore, low-frequency stimulation may play a role in treating ataxic speech.\nHighlights\nThe finding of this case study suggests that bilateral low-frequency DBS at 30 Hz in the caudal zona incerta has the potential to improve ataxic speech but has limited impact on gait and stance. The involvement of zona incerta in speech warrants further investigation.<\/jats:p>","DOI":"10.5334\/tohm.925","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:58:41Z","timestamp":1724288321000},"page":"42","source":"Crossref","is-referenced-by-count":3,"title":["Effects of Low-Frequency Deep Brain Stimulation in Bilateral Zona Incerta for a Patient With Tremor and Cerebellar Ataxia"],"prefix":"10.5334","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3775-6747","authenticated-orcid":false,"given":"Ami","family":"Kumar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5936-5686","authenticated-orcid":false,"given":"Kristen L.","family":"Matulis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4777-7464","authenticated-orcid":false,"given":"Zena A.","family":"Fadel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4835-3046","authenticated-orcid":false,"given":"Alexander S.","family":"Fanning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0249-5548","authenticated-orcid":false,"given":"Christian J.","family":"Amlang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9412-931X","authenticated-orcid":false,"given":"Sheng-Han","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3285","published-online":{"date-parts":[[2024,8,21]]},"reference":[{"issue":"4","key":"key20240822005838_B1","first-page":"1036","article-title":"Ataxia","volume":"25","year":"2019","journal-title":"Continuum (Minneapolis, Minn)"},{"issue":"1","key":"key20240822005838_B2","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1055\/s-0043-1763511","article-title":"Ataxias: Hereditary, Acquired, and Reversible Etiologies","volume":"43","year":"2023","journal-title":"Seminars in neurology"},{"issue":"2","key":"key20240822005838_B3","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/S1474-4422(10)70322-7","article-title":"Treatment of patients with essential tremor","volume":"10","year":"2011","journal-title":"The Lancet Neurology"},{"issue":"4","key":"key20240822005838_B4","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1007\/s13311-020-00899-2","article-title":"Managing Essential Tremor","volume":"17","year":"2020","journal-title":"Neurotherapeutics: the journal of the American Society for Experimental NeuroTherapeutics"},{"key":"key20240822005838_B5","first-page":"241","volume-title":"Stereotactic and functional neurosurgery","year":"2019"},{"issue":"5","key":"key20240822005838_B6","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1002\/mds.21338","article-title":"Subthalamic-thalamic DBS in a case with spinocerebellar ataxia type 2 and severe tremor-A unusual clinical benefit","volume":"22","year":"2007","journal-title":"Movement disorders: official journal of the Movement Disorder Society"},{"key":"key20240822005838_B7","first-page":"1048530","year":"2022"},{"issue":"8","key":"key20240822005838_B8","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1007\/s00701-007-1230-1","article-title":"Deep brain stimulation in the subthalamic area is more effective than nucleus ventralis intermedius stimulation for bilateral intention tremor","volume":"149","year":"2007","journal-title":"Acta neurochirurgica"},{"issue":"8","key":"key20240822005838_B9","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1136\/jnnp.2010.222992","article-title":"Bilateral caudal zona incerta nucleus stimulation for essential tremor: outcome and quality of life","volume":"82","year":"2011","journal-title":"Journal of neurology, neurosurgery, and psychiatry"},{"key":"key20240822005838_B10","doi-asserted-by":"crossref","first-page":"116511","DOI":"10.1016\/j.neuroimage.2019.116511","article-title":"Deep brain stimulation in the caudal zona incerta modulates the sensorimotor cerebello-cerebral circuit in essential tremor","volume":"209","year":"2020","journal-title":"NeuroImage"},{"issue":"6","key":"key20240822005838_B11","first-page":"e543","article-title":"DBS of the PSA and the VIM in essential tremor: A randomized, double-blind, crossover trial","volume":"91","year":"2018","journal-title":"Neurology"},{"key":"key20240822005838_B12","doi-asserted-by":"crossref","first-page":"100024","DOI":"10.1016\/j.wnsx.2019.100024","article-title":"Voice Tremor Response to Deep Brain Stimulation in Relation to Electrode Location in the Posterior Subthalamic Area","volume":"3","year":"2019","journal-title":"World neurosurgery: X"},{"issue":"1","key":"key20240822005838_B13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.neuroscience.2004.08.017","article-title":"Some certainty for the \u201czone of uncertainty\u201d? Exploring the function of the zona incerta","volume":"130","year":"2005","journal-title":"Neuroscience"},{"issue":"4","key":"key20240822005838_B14","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s00429-002-0259-4","article-title":"Distinctive patterns of connectivity between the zona incerta and the red nucleus of rats","volume":"205","year":"2002","journal-title":"Anatomy and embryology"},{"issue":"2","key":"key20240822005838_B15","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s004290100187","article-title":"Organisation of connections between the zona incerta and the interposed nucleus","volume":"204","year":"2001","journal-title":"Anatomy and embryology"},{"issue":"4","key":"key20240822005838_B16","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1002\/cne.10971","article-title":"Evidence for a glutamatergic projection from the zona incerta to the basal ganglia of rats","volume":"468","year":"2004","journal-title":"The Journal of comparative neurology"},{"issue":"2","key":"key20240822005838_B17","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1002\/cne.903600208","article-title":"Orthograde axonal transport studies of projections from the zona incerta and pretectum to the basilar pontine nuclei in the rat","volume":"360","year":"1995","journal-title":"The Journal of comparative neurology"},{"issue":"1","key":"key20240822005838_B18","first-page":"210","article-title":"A Systematic Review of Direct Outputs from the Cerebellum to the Brainstem and Diencephalon in Mammals","volume":"23","year":"2024","journal-title":"Cerebellum (London, England)"},{"issue":"5","key":"key20240822005838_B19","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1002\/ana.25464","article-title":"Deep cerebellar stimulation reduces ataxic motor symptoms in the shaker rat","volume":"85","year":"2019","journal-title":"Annals of neurology"},{"issue":"1","key":"key20240822005838_B20","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1038\/s41467-021-21417-8","article-title":"Neuromodulation of the cerebellum rescues movement in a mouse model of ataxia","volume":"12","year":"2021","journal-title":"Nature communications"},{"key":"key20240822005838_B21","year":"1993"},{"issue":"11","key":"key20240822005838_B22","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1212\/01.wnl.0000219042.60538.92","article-title":"Scale for the assessment and rating of ataxia: development of a new clinical scale","volume":"66","year":"2006","journal-title":"Neurology"},{"issue":"12","key":"key20240822005838_B23","doi-asserted-by":"crossref","first-page":"2922","DOI":"10.1002\/mds.28740","article-title":"Gait Variability in Spinocerebellar Ataxia Assessed Using Wearable Inertial Sensors","volume":"36","year":"2021","journal-title":"Movement disorders: official journal of the Movement Disorder Society"},{"issue":"9\u201310","key":"key20240822005838_B24","first-page":"341","article-title":"Speak and unSpeak with Praat","volume":"5","year":"2001","journal-title":"Glot International"},{"issue":"5","key":"key20240822005838_B25","first-page":"865","article-title":"ClearSpeechTogether: a Rater Blinded, Single, Controlled Feasibility Study of Speech Intervention for People with Progressive Ataxia","volume":"22","year":"2023","journal-title":"Cerebellum [Internet]"},{"issue":"1","key":"key20240822005838_B26","first-page":"112","article-title":"Perceptual and Acoustic Analysis of Speech in Spinocerebellar ataxia Type 1","volume":"23","year":"2024","journal-title":"Cerebellum (London, England)"},{"issue":"10","key":"key20240822005838_B27","article-title":"Speech, Gait, and Vestibular Function in Cerebellar Ataxia with Neuropathy and Vestibular Areflexia Syndrome","volume":"13","year":"2023","journal-title":"Brain Sciences"},{"issue":"16","key":"key20240822005838_B28","doi-asserted-by":"crossref","first-page":"4748","DOI":"10.1002\/hbm.24734","article-title":"Cerebellar contribution to auditory feedback control of speech production: Evidence from patients with spinocerebellar ataxia","volume":"40","year":"2019","journal-title":"Human Brain Mapping"},{"issue":"1","key":"key20240822005838_B29","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.jvoice.2014.06.015","article-title":"Objective dysphonia measures in the program Praat: smoothed cepstral peak prominence and acoustic voice quality index","volume":"29","year":"2015","journal-title":"Journal of voice: official journal of the Voice Foundation"},{"key":"key20240822005838_B30","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.nicl.2016.11.019","article-title":"Probabilistic mapping of deep brain stimulation effects in essential tremor","volume":"13","year":"2017","journal-title":"NeuroImage Clinical"}],"container-title":["Tremor and Other Hyperkinetic Movements"],"original-title":[],"link":[{"URL":"https:\/\/account.tremorjournal.org\/index.php\/up-j-tohm\/article\/download\/925\/1894","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.tremorjournal.org\/index.php\/up-j-tohm\/article\/download\/925\/1895","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.tremorjournal.org\/index.php\/up-j-tohm\/article\/download\/925\/1896","content-type":"audio\/mpeg","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.tremorjournal.org\/index.php\/up-j-tohm\/article\/download\/925\/1897","content-type":"audio\/mpeg","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.tremorjournal.org\/index.php\/up-j-tohm\/article\/download\/925\/1898","content-type":"audio\/mpeg","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/account.tremorjournal.org\/index.php\/up-j-tohm\/article\/download\/925\/1894","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T10:46:36Z","timestamp":1782816396000},"score":1,"resource":{"primary":{"URL":"https:\/\/account.tremorjournal.org\/index.php\/up-j-tohm\/article\/view\/925"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,21]]},"references-count":30,"URL":"https:\/\/doi.org\/10.5334\/tohm.925","relation":{},"ISSN":["2160-8288"],"issn-type":[{"value":"2160-8288","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,21]]}}}