Objective: To investigate neurologists’ perceptions of treatment effectiveness and criteria for selecting patients for advanced therapies in essential tremor (ET) and Parkinson’s disease (PD).
Background: Essential tremor is reported to be more prevalent than Parkinson’s disease; however, differences in clinical presentation, perceived disease burden, and therapeutic decision-making may influence real-world management. Understanding how neurologists perceive these differences may provide insight into current treatment patterns and the use of advanced therapies.
Method: A structured survey was conducted among 270 European neurologists, including 175 general neurologists (GN) and 95 movement disorder specialists (MDS). The survey assessed clinical practice patterns in ET and PD, including patient volume, perceived disease severity, response to pharmacological treatment, and criteria for selecting candidates for advanced therapies.
Results: Despite the higher prevalence of ET, both GN and MDS reported managing a higher number of patients with PD (ET 26-29, PD 41-49 patients) [Figure1]. Pharmacological therapy was perceived as effective for “the majority of patients” by only 18.9±2.7% of neurologists for ET compared with 44.4±6.6% for PD [Figure 2]. Still the proportion of patients considered eligible for MR-Guided Focused Ultrasound (MRgFUS) was similar across conditions (1–20% of patients: 54.5% ET vs 52.3% PD; 21–40%: 22.5% ET vs 24.4% PD) [Figure 3]. Moreover, neurologists reported selecting patients with less advanced disease for MRgFUS in PD compared with ET (Mild-Moderate patients: 21.7±4.6% in ET, 32.9 ±2.9% in PD) [Figure 4]. In ET, MRgFUS was no longer predominantly viewed as a secondary option limited to patients ineligible for deep brain stimulation (13.9%), whereas this perception remained more common in PD (22.7%).
Conclusion: These observations reveal a gap between pharmacologic-control and real-world adoption of advanced-therapy in ET and PD. Future efforts, should aim to improve the alignment of treatment pathways with clinical need, improving the patient journey and reducing the time patients spend without access to recommended therapies.
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To cite this abstract in AMA style:
N. Kaempf, á. Sánchez Fraga, C. Tengelin, P. Crivelli, K. Gant, C. Ferrer, A. Grinspan. Remaining unmet needs in Essential Tremor and Parkinson’s Disease: European Neurologists’ Assessments of Pharmacologic Response and Advanced Therapy Use [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/remaining-unmet-needs-in-essential-tremor-and-parkinsons-disease-european-neurologists-assessments-of-pharmacologic-response-and-advanced-therapy-use/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/remaining-unmet-needs-in-essential-tremor-and-parkinsons-disease-european-neurologists-assessments-of-pharmacologic-response-and-advanced-therapy-use/