updating this thread now January 2015:
Mac after update to OSX 10.8.5, Wacom tablet issue with laggy or jerky pen draw when using ZBrush 4R6. ( 4R7 yet untested)
Preferences >Performance >MultiDraw - switching this off resolved a wacom issue where sculpting became impossible due to jerky pen -this issue not present running ZBrush 4R6 in osx 10.6.8.
Addendum:
After testing first release of ZBrushOSX 4R7 (jan 2015) running OSX 10.8.5 - jerky , stuttering wacom pen performance still occurs. Switching off MultiDraw in Preferences >Performance and/ or switching MultiThreads (Preferences >Performance ) down to 1 seems to fix/ greatly help the issue for the most part.
Tried deinstalling and reinstalling multiple versions of Wacom drivers from the latest release to legacy drivers, all to no avail. Also tested, Graphire, Intuos2 and Intuos 4 - all displayed same issue running ZBrush 4R6 and 4R7 on 0SX 10.8.5 regardless of driver.
It would be great to find a fix for this issue within the 4R7 release cycle.