Precise stimulation location optimizes speech outcomes in essential tremor.

•The effects of bilateral DBS for essential tremor on speech was studied in 18 patients.•22% of patients developed a mild to moderate dysarthria after surgery.•Only 44% of patients had an optimal speech outcome without dysarthria or tremor.•Dysarthria patients had less precise placement of electrodes in the VLP nucleus.•Optimal speech outcomes correlated with precise stimulation location.