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Objective <p>To evaluate the feasibility, safety, and preliminary efficacy of a novel single-lead, dual-target deep brain stimulation (DBS) approach targeting the posterior subthalamic area (PSA) and subthalamic nucleus (STN) for dystonic tremor.</p> Methods <p>This retrospective pilot study reviewed outcomes of six consecutive patients with medically refractory dystonic tremor who underwent single-lead PSA-STN DBS at our center (June–December 2024). Clinical outcomes were assessed using the BFMDRS and FTMTRS scales. A formal blinded crossover assessment was performed in three patients to compare PSA-only, STN-only, and combined stimulation. Chronic settings were selected via patient-directed optimization.</p> Results <p>All six patients completed follow-up (100% retention) and achieved stable chronic stimulation programs. Five patients (83.3%) independently selected combined PSA + STN stimulation; one preferred STN-only. At LFU (6–12&#xa0;months postoperatively), the mean BFMDRS-Motor score decreased by 78.1% and FTMTRS by 87.1%. The crossover assessment (<i>n</i> = 3) showed that combined stimulation outperformed single-target stimulation. No serious adverse events occurred. All efficacy analyses are exploratory.</p> Conclusion <p>This single-lead, dual-target PSA-STN DBS approach demonstrates feasibility and preliminary efficacy for dystonic tremor. Prospective controlled trials are warranted.</p>

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Efficacy and safety of single-trajectory posterior subthalamic area and subthalamic nucleus deep brain stimulation for dystonic tremor: a retrospective pilot study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月6日

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  • Jianyi Shen,
  • Zhengyu Lin,
  • Suzhen Lin,
  • Peng Huang,
  • Yixin Pan,
  • Bomin Sun,
  • Jianqing Ding,
  • Yiwen Wu,
  • Dianyou Li

摘要

Objective

To evaluate the feasibility, safety, and preliminary efficacy of a novel single-lead, dual-target deep brain stimulation (DBS) approach targeting the posterior subthalamic area (PSA) and subthalamic nucleus (STN) for dystonic tremor.

Methods

This retrospective pilot study reviewed outcomes of six consecutive patients with medically refractory dystonic tremor who underwent single-lead PSA-STN DBS at our center (June–December 2024). Clinical outcomes were assessed using the BFMDRS and FTMTRS scales. A formal blinded crossover assessment was performed in three patients to compare PSA-only, STN-only, and combined stimulation. Chronic settings were selected via patient-directed optimization.

Results

All six patients completed follow-up (100% retention) and achieved stable chronic stimulation programs. Five patients (83.3%) independently selected combined PSA + STN stimulation; one preferred STN-only. At LFU (6–12 months postoperatively), the mean BFMDRS-Motor score decreased by 78.1% and FTMTRS by 87.1%. The crossover assessment (n = 3) showed that combined stimulation outperformed single-target stimulation. No serious adverse events occurred. All efficacy analyses are exploratory.

Conclusion

This single-lead, dual-target PSA-STN DBS approach demonstrates feasibility and preliminary efficacy for dystonic tremor. Prospective controlled trials are warranted.