Convergent mapping of a tremor treatment network

Lukas L. Goede (), Bassam Al-Fatly, Ningfei Li, Leon K. Sobesky, Bahne H. Bahners, Patricia Zvarova, Clemens Neudorfer, Martin Reich, Jens Volkmann, Chencheng Zhang, Vincent J. J. Odekerken, Rob M. A. Bie, Ellen F. P. Younger, Daniel T. Corp, Erik H. Middlebrooks, Juho Joutsa, Michiel Dirkx, Günther Deuschl, Rick C. Helmich, Andrea A. Kühn, Michael D. Fox and Andreas Horn
Additional contact information
Lukas L. Goede: Harvard Medical School
Bassam Al-Fatly: Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin
Ningfei Li: Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin
Leon K. Sobesky: Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin
Bahne H. Bahners: Harvard Medical School
Patricia Zvarova: Harvard Medical School
Clemens Neudorfer: Harvard Medical School
Martin Reich: University Hospital Würzburg
Jens Volkmann: University Hospital Würzburg
Chencheng Zhang: Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine
Vincent J. J. Odekerken: University of Amsterdam
Rob M. A. Bie: University of Amsterdam
Ellen F. P. Younger: Deakin University
Daniel T. Corp: Deakin University
Erik H. Middlebrooks: Mayo Clinic
Juho Joutsa: University of Turku
Michiel Dirkx: Radboud University Medical Centre
Günther Deuschl: Christian-Albrechts-University Kiel
Rick C. Helmich: Radboud University Medical Centre
Andrea A. Kühn: Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin
Michael D. Fox: Harvard Medical School
Andreas Horn: Harvard Medical School

Nature Communications, 2025, vol. 16, issue 1, 1-11

Abstract: Abstract 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.

Date: 2025
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DOI: 10.1038/s41467-025-60089-6

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