Convergent mapping of a tremor treatment network
Tremor occurs in various forms across diverse neurological disorders, including Parkinson's disease and essential tremor. While clinically heterogeneous, converging evidence suggests a shared brain network may underlie tremor across conditions. Here, we empirically define such a network using four modalities: lesion locations, atrophy patterns, EMG-fMRI, and deep brain stimulation outcomes. We show that network connectivity robustly explains clinical outcomes in independent cohorts undergoing deep brain stimulation of the subthalamic nucleus for Parkinson's disease and the ventral intermediate nucleus for essential tremor. Maps from each cohort accounted for outcomes in the respective other, supporting a disorder-independent tremor network. A multimodal agreement map revealed consistent substrates in the primary motor cortex and motor cerebellum. To validate the network, we test its predictive power in a third, independent cohort treated with pallidal stimulation for Parkinson's disease. Our findings define a robust, cross-condition tremor network that may guide both invasive and noninvasive neuromodulation strategies.
Authors
- Clemens Neudorfer (ORCID: https://orcid.org/0000-0002-3153-1045)
- Andrea A. Kühn (ORCID: https://orcid.org/0000-0002-4134-9060)
- Chencheng Zhang (ORCID: https://orcid.org/0000-0003-4472-4134)
- Bahne H. Bahners (ORCID: https://orcid.org/0000-0003-1963-9798)
- Rick C. G. Helmich (ORCID: https://orcid.org/0000-0003-4035-6573)
- Martin M. Reich (ORCID: https://orcid.org/0000-0001-9115-5136)
- Bassam Al‐Fatly (ORCID: https://orcid.org/0000-0003-0067-6177)
- Erik H. Middlebrooks (ORCID: https://orcid.org/0000-0002-4418-9605)
- Jens Volkmann (ORCID: https://orcid.org/0000-0002-9570-593X)
- Andreas Horn (ORCID: https://orcid.org/0000-0002-0695-6025)
- Rob M. A. de Bie (ORCID: https://orcid.org/0000-0001-5267-0784)
- Michiel F. Dirkx (ORCID: https://orcid.org/0000-0001-8763-8071)
- Ningfei Li (ORCID: https://orcid.org/0000-0003-3315-3591)
- Lukas L. Goede (ORCID: https://orcid.org/0000-0001-6026-185X)
- Vincent J.J. Odekerken (ORCID: https://orcid.org/0000-0001-9096-9146)
- Juho Joutsa (ORCID: https://orcid.org/0000-0002-3457-9415)
- Günther Deuschl (ORCID: https://orcid.org/0000-0002-4176-9196)
- Leon Sobesky (ORCID: https://orcid.org/0000-0001-7176-6546)
- Ellen Younger
- Michael Fox (ORCID: https://orcid.org/0000-0001-8848-6399)
- Patricia Zvarova (ORCID: https://orcid.org/0009-0004-7831-8796)
Institutions
- Brigham and Women's Hospital (US)
- Radboud University Nijmegen (NL)
- Deakin University (AU)
- University of Turku (FI)
- Ruijin Hospital (CN)
- Turku University Hospital (FI)
- WinnMed (US)
- Radboud University Medical Center (NL)
- Christian-Albrechts-Universität zu Kiel (DE)
- Humboldt-Universität zu Berlin (DE)
- Massachusetts General Hospital (US)
- Düsseldorf University Hospital (DE)
- Circuit Therapeutics (United States) (US)
- Universitätsklinikum Würzburg (DE)
- Mayo Clinic in Florida (US)
- Amsterdam University Medical Centers (NL)
- University Hospital Cologne (DE)
- Heinrich Heine University Düsseldorf (DE)
- University of Amsterdam (NL)
Publication Details
- Journal
- Nature Communications
- Published
- 2025-05-22
- DOI
- https://doi.org/10.1038/s41467-025-60089-6
- Citations
- 7
- Primary Topic
- Neurological disorders and treatments
- Type
- article
- Field-Weighted Citation Impact
- 9.72
Funders
- Suomen Lääketieteen Säätiö
- EU Joint Programme – Neurodegenerative Disease Research
- Deutsche Forschungsgemeinschaft
- Turun Yliopisto
- Turun Yliopistollinen Keskussairaala
- Thiemann Stiftung
- Berlin Institute of Health
- National Institutes of Health
- Parkinsonfonden
- McDonnell Center for Systems Neuroscience