Subthalamic stimulation has greater modulatory effect on the amplitude and rhythm of resting tremor than postural tremor in Parkinson’s disease

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Abstract Resting and postural tremor in Parkinson’s disease have distinct clinical characteristics and treatment responses. Subthalamic stimulation is superior to best medical therapy for tremor control, but its effects on the kinematic properties of different tremor types remain partially understood. We recruited thirty-one patients with Parkinson’s disease at least one year after subthalamic deep brain stimulation surgery. Using 3D gyroscope measurements, we examined how stimulation alters amplitude, peak amplitude frequency, and rhythmicity in resting and postural tremor. We collected clinical data and measured the distance of active contacts from the centroid of dorsolateral subthalamic nucleus to test whether these factors predict stimulation-induced changes. We found that resting tremor showed higher amplitude and responded more robustly to stimulation than postural tremor. Peak amplitude frequency increased similarly in both tremor types, shifting toward the physiological range. Only resting tremor lost rhythmicity; postural tremor did not. Improvement in resting tremor amplitude could be predicted from the preoperative motor scores under medication effect, disease duration at the time of surgery, active contact location, and age at disease onset. Our findings suggest that subthalamic stimulation blocks a single pacemaker in resting tremor but only partially affects the compound oscillatory network underlying postural tremor in Parkinson’s disease.

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