{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:07:52Z","timestamp":1787497672091,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Management of deep brain stimulation (DBS) in late\u2010stage Parkinson's disease (LSPD) remains challenging, particularly when deciding whether to continue or discontinue stimulation, and evidence on risk\u2013benefit considerations is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify key factors to improve decision\u2010making in DBS management for LSPD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed demographic, clinical and stimulation parameters in LSPD patients (Hoehn and Yahr \u22654; Schwab and England \u226450) who either maintained best medical therapy (BMT) or required unscheduled device\u2010aided therapy (DAT) implantation up to 1\u2009year after DBS discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 2005 to 2022, 94 patients with bilateral subthalamic nucleus DBS were reviewed and among the 31 patients who have transitioned to LSPD, 15 patients remained on BMT, while 10 required rescue DAT (6 unscheduled implantable pulse generator replacements and 4 Levodopa\u2010Carbidopa Intestinal Gel) within 3\u2009months after discontinuation. Significant differences were observed in years of DBS (12.4 vs. 8.5), modified Falls Efficacy Scale (12.5 vs. 21.2), and months since the last parameter adjustment (30.3 vs. 23.2), with a trend toward less \u0394MDS\u2010UPDRS III worsening after stimulation was switched off (7.6 vs. 10.9). Longer DBS duration was inversely associated with rescue DAT (OR 0.529; 95% CI, 0.284\u20130.986), with a cutoff of 10.5\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In selected LSPD patients, a transition from DBS to BMT alone can be attempted with long\u2010term stability, whereas in others a more conservative approach is advisable, and stimulation should be continued. Clinical, therapeutic, and care\u2010related factors should guide decisions when discontinuation is being considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70558","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T07:01:25Z","timestamp":1771052485000},"page":"1918-1925","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk\u2010Benefit Considerations in Deep Brain Stimulation Discontinuation for Late\u2010Stage Parkinson's Disease"],"prefix":"10.1002","volume":"13","author":[{"given":"Pietro","family":"Antenucci","sequence":"first","affiliation":[{"name":"Unit of Clinical Neurology, Interdistrict Department of Neuroscience and Rehabilitation University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Gozzi","sequence":"additional","affiliation":[{"name":"Unit of Neurology, Interdistrict Department of Neuroscience Sant'Anna University\u2010Hospital  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1945-8153","authenticated-orcid":false,"given":"Fabiana","family":"Colucci","sequence":"additional","affiliation":[{"name":"Parkinson and Movement Disorders Unit, Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Pes","sequence":"additional","affiliation":[{"name":"Unit of Clinical Neurology, Interdistrict Department of Neuroscience and Rehabilitation University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay Guido","family":"Capone","sequence":"additional","affiliation":[{"name":"Unit of Neurology, Interdistrict Department of Neuroscience Sant'Anna University\u2010Hospital  Ferrara Italy"},{"name":"Neurophysiology Unit, Interdistrict Department of Neuroscience Sant'Anna University\u2010Hospital  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Scerrati","sequence":"additional","affiliation":[{"name":"Unit of Neurosurgery, Arcispedale Sant'Anna Hospital  Ferrara Italy"},{"name":"Department of Translational Medicine University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele Alessandro","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Unit of Neurosurgery, Arcispedale Sant'Anna Hospital  Ferrara Italy"},{"name":"Department of Translational Medicine University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Pugliatti","sequence":"additional","affiliation":[{"name":"Unit of Clinical Neurology, Interdistrict Department of Neuroscience and Rehabilitation University of Ferrara  Ferrara 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