Reader response: DBS of the PSA and the VIM in essential tremor: A randomized, double-blind, crossover trial

Abstract

I congratulate Barbe et al.1 for their elegant study, which sought to address the important clinical topic of deep brain stimulation of the posterior subthalamic area vs the ventral intermediate nucleus of the thalamus in essential tremor. In the study, 3 different leads were used1; could the differences in spacing affect accurate activation of intended targets, and the reported results, as the center of the active electrodes lies 3.0–3.5 mm below the intercommissural line in most studies?2 Also, it may have been beneficial to mention the type of lead used for each patient in the Open Science Framework data tables to correlate with stimulation settings, as well as exploring lower (<60 μs) pulse widths when using Boston Scientific leads.3 Moreover, when using the constant current mode with Medtronic leads, configuration options are limited due to a single current source, as opposed to the Boston Scientific leads, not allowing for refined programming.