The research has been approved by the Chinese Clinical Trial Registry (Registration No.: ChiCTR2100054804) and the local Ethics Committee of Shanghai Jiao Tong University, China (Approved No. of Ethic Committee: 2019 Clinical Trial No. 136). All subjects provided written consent after being informed of the purpose and the procedures of the experiment. The overall experiment was strictly performed in accordance with all relevant guidelines and regulations of the institutional review board and the Declaration of Helsinki. Patients were recruited by the department of neurology of Rui Jin Hospital (Shanghai, China). All of them were out-patients with upper limb tremor resulted from Parkinson's disease (Excluded N = 11; Not meeting the inclusion criteria N = 7; Declined to participate N = 4) (Figure 1 ).
The inclusion criteria for subjects were: (1) age between 50 and 80 years old, (2) confirmed diagnosis of idiopathic Parkinson's disease according to the MDS clinical diagnostic criteria for PD (Postuma et al., 2015 (link)), (3) symptom of upper limb tremor (rest tremor or postural tremor) resulted from PD, and (4) modified Hoen & Yahr (H&Y) Stage 1 to 3 (Hoehn and Yahr, 1967 (link)). The exclusion criteria included: (1) history of other diseases that may lead to pathological tremor, such as essential tremor (Deuschl et al., 1998 (link)), (2) under the treatment of other neuromodulation therapy, such as DBS, within recent 1 month, (3) history of mental problems, including anxiety, dementia, hallucination or delusion etc., (4) strong reliance on anti-Parkinson medications, or (5) history of cognitive disorder [Mini-mental State Examination (MMSE) score ≤ 16] (Tombaugh and McIntyre, 1992 (link)).
The average disease duration of PD among all subjects [7M/6F, all right-handed, aged 67.5 ± 4.9 (mean ± SD)] were 4.38 ± 1.86 (mean ± SD) years. The Unified Parkinson's Disease Rating Scale (UPDRS) score ranged from 20 to 78 [31.7 ± 15.4 (mean ± SD)] while the modified H&Y stage ranged from 1.0 to 3.0 [1.8 ± 0.8 (mean ± SD)]. The tremor was found to be lateralized in all subjects. Throughout the manuscript, we refer to the more-affected side (MAS) as the side of body exhibiting more severe tremor, which was determined visually by an experienced physician, while the less-affected side (LAS)was defined as the other. Of all subjects, about half (n = 7) were found to be more-affected by tremor on the left side with the other half (n = 6) on the right side. The average levodopa-equivalent daily dose (LEDD) among all subjects was 278.8 ± 203.3 (mean ± SD) mg according to the calculation protocol provided by Tomlinson et al. (2010 (link)). In order to exclude drug effects, all subjects were told to discontinue anti-Parkinson medications on the day of the experiment, which ensured a withdrawal period of more than 12 h. Anti-Parkinson medications were resumed immediately after the experiment session of the day.
The inclusion criteria for subjects were: (1) age between 50 and 80 years old, (2) confirmed diagnosis of idiopathic Parkinson's disease according to the MDS clinical diagnostic criteria for PD (Postuma et al., 2015 (link)), (3) symptom of upper limb tremor (rest tremor or postural tremor) resulted from PD, and (4) modified Hoen & Yahr (H&Y) Stage 1 to 3 (Hoehn and Yahr, 1967 (link)). The exclusion criteria included: (1) history of other diseases that may lead to pathological tremor, such as essential tremor (Deuschl et al., 1998 (link)), (2) under the treatment of other neuromodulation therapy, such as DBS, within recent 1 month, (3) history of mental problems, including anxiety, dementia, hallucination or delusion etc., (4) strong reliance on anti-Parkinson medications, or (5) history of cognitive disorder [Mini-mental State Examination (MMSE) score ≤ 16] (Tombaugh and McIntyre, 1992 (link)).
The average disease duration of PD among all subjects [7M/6F, all right-handed, aged 67.5 ± 4.9 (mean ± SD)] were 4.38 ± 1.86 (mean ± SD) years. The Unified Parkinson's Disease Rating Scale (UPDRS) score ranged from 20 to 78 [31.7 ± 15.4 (mean ± SD)] while the modified H&Y stage ranged from 1.0 to 3.0 [1.8 ± 0.8 (mean ± SD)]. The tremor was found to be lateralized in all subjects. Throughout the manuscript, we refer to the more-affected side (MAS) as the side of body exhibiting more severe tremor, which was determined visually by an experienced physician, while the less-affected side (LAS)was defined as the other. Of all subjects, about half (n = 7) were found to be more-affected by tremor on the left side with the other half (n = 6) on the right side. The average levodopa-equivalent daily dose (LEDD) among all subjects was 278.8 ± 203.3 (mean ± SD) mg according to the calculation protocol provided by Tomlinson et al. (2010 (link)). In order to exclude drug effects, all subjects were told to discontinue anti-Parkinson medications on the day of the experiment, which ensured a withdrawal period of more than 12 h. Anti-Parkinson medications were resumed immediately after the experiment session of the day.
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