{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:47:33Z","timestamp":1787802453852,"version":"build-2784847793"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,11,8]],"date-time":"2018-11-08T00:00:00Z","timestamp":1541635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The use of alternate frequencies, amplitudes, and pulse widths to manage motor symptoms in Parkinson's disease (PD) patients with subthalamic nucleus deep brain stimulation (STN\u2010DBS) is of clinical interest, but currently lacks systematic evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective\/Hypothesis<\/jats:title><jats:p>Systematically review whether alternate STN\u2010DBS settings influence the therapy's efficacy for managing PD motor symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Systematic searches identified studies that; involved bilateral STN\u2010DBS PD patients; manipulated\u2009\u2265\u20091 STN\u2010DBS parameter (e.g., amplitude); assessed\u2009\u2265\u20091 motor symptom (e.g., tremor); and contrasted the experimental and chronic stimulation settings. A Mantel\u2010Haenszel random\u2010effects meta\u2010analysis compared the UPDRS\u2010III sub\u2010scores at low (60\u2010Hz) and high frequencies (\u2009\u2265\u2009130\u2009Hz). Inter\u2010study heterogeneity was assessed with the Cohen's \u03c7<jats:sup>2<\/jats:sup> and I<jats:sup>2<\/jats:sup> index, while the standard GRADE evidence assessment examined strength of evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 21 included studies, 17 investigated the effect of alternate stimulation frequencies, five examined alternate stimulation amplitudes, and two studied changes in pulse width. Given the available data, meta\u2010analyses were only possible for alternate stimulation frequencies. Analysis of the heterogeneity amongst the included studies indicated significant variability between studies and, on the basis of the GRADE framework, the pooled evidence from the meta\u2010analysis studies was of very low quality due to the significant risks of bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The meta\u2010analysis reported a very low quality of evidence for the efficacy of low\u2010frequency STN\u2010DBS for managing PD motor symptoms. Furthermore, it highlighted that lower amplitudes lead to the re\u2010emergence of motor symptoms and further research is needed to understand the potential benefits of alternate STN\u2010DBS parameters for PD patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.12681","type":"journal-article","created":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T01:54:37Z","timestamp":1536717277000},"page":"17-26","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Alternate Subthalamic Nucleus Deep Brain Stimulation Parameters to Manage Motor Symptoms of Parkinson's Disease: Systematic Review and Meta\u2010analysis"],"prefix":"10.1002","volume":"6","author":[{"given":"Zachary J.","family":"Conway","sequence":"first","affiliation":[{"name":"School of Behavioural and Health Sciences Australian Catholic University Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter 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