{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:36:40Z","timestamp":1761007000232,"version":"build-2065373602"},"reference-count":6,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,6,9]],"date-time":"2024-06-09T00:00:00Z","timestamp":1717891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2024,8]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>In our early experience programming directional deep brain stimulation (d\u2010DBS) in PD, we found the optimal directional segment changed over time in some patients. To determine the frequency\/reasons for this we examined whether (1) different programmers would identify the same segment as \u201coptimal\u201d; and (2) the same programmer would select the same \u201coptimal\u201d segment over time. We hypothesized there would be a moderately high level of agreement on optimal electrode selection between different assessors and repeated assessments by the same evaluator.<\/jats:p><\/jats:sec>Methods<\/jats:title>This was a prospective, double\u2010blind investigation evaluating the reliability and stability of programming d\u2010DBS. Each patient underwent a mono\u2010polar survey four times (2 time points by 2 separate assessors). The primary aim was the inter\u2010rater agreement of selecting the optimal electrode at 1 and 6 months. The secondary aim was to determine the intra\u2010rater agreement of selecting the optimal electrode from 1 to 6 months.<\/jats:p><\/jats:sec>Results<\/jats:title>Twenty\u2010one patients were enrolled. There was fair inter\u2010rater agreement at 1 month and moderate at 6 months. There was minimal intra\u2010rater agreement between 1 and 6 months.<\/jats:p><\/jats:sec>Discussion<\/jats:title>The data refuted our hypothesis. Potential reasons for low agreement include (1) the arduous\/subjective nature of identifying the optimal electrode in d\u2010DBS systems, especially in well\u2010placed electrodes; and\/or (2) acute changes to the location of stimulation delivery offering temporary improvement in symptoms. Key takeaways gathered were it may, (1) behoove the programmer to explore different electrode montages after a period of time; and (2) be more efficient to review the directional electrode montage only when dictated by clinical symptoms\/disease progression.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.14120","type":"journal-article","created":{"date-parts":[[2024,6,10]],"date-time":"2024-06-10T01:18:40Z","timestamp":1717982320000},"page":"992-997","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Directional Deep Brain Stimulation Programming: Is the Segment Clearly Identifiable and Stable Over Time?"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8030-1939","authenticated-orcid":false,"given":"Jessica A.","family":"Karl","sequence":"first","affiliation":[{"name":"Movement Disorder Division, Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica M.","family":"Joyce","sequence":"additional","affiliation":[{"name":"Department of Neurology Rush University Medical Center Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bichun","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Neurology Rush University Medical Center Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandler E.","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Neurology Rush University Medical Center Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo","family":"Verhagen Metman","sequence":"additional","affiliation":[{"name":"Movement Disorder Division, Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,6,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.13407"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27093"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2017.12.015"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2007.08.004"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2019.08.017"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40120-022-00381-5"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.14120","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:18:06Z","timestamp":1760959086000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.14120"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,9]]},"references-count":6,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1002\/mdc3.14120"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.14120","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"type":"print","value":"2330-1619"},{"type":"electronic","value":"2330-1619"}],"subject":[],"published":{"date-parts":[[2024,6,9]]},"assertion":[{"value":"2024-01-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}