{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:28:49Z","timestamp":1790987329272,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"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"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Parkinson's disease (\n PD<\/jats:styled-content>\n ) causes progressive motor and non\u2010motor disability. Although pharmacotherapy is first\u2010line, responses diminish over time. Deep brain stimulation (\n DBS<\/jats:styled-content>\n ) effectively treats advanced\n PD<\/jats:styled-content>\n , and recent data suggest benefits when applied earlier.\n <\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n \n To systematically review studies and meta\u2010analyze randomized controlled trials comparing subthalamic\n DBS<\/jats:styled-content>\n plus best medical therapy (\n BMT<\/jats:styled-content>\n ) with\n BMT<\/jats:styled-content>\n alone in early\n PD<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We conducted a systematic review and meta\u2010analysis according to\n PRISMA<\/jats:styled-content>\n , with a protocol registered in\n PROSPERO<\/jats:styled-content>\n (\n CRD420251014105<\/jats:styled-content>\n ).\n MEDLINE<\/jats:styled-content>\n , Embase, and the Cochrane Library (2002\u20132025) were searched for studies comparing early\n DBS<\/jats:styled-content>\n with\n BMT<\/jats:styled-content>\n in \u201cearly\u201d\n PD<\/jats:styled-content>\n . \u201cEarly\u201d was variably defined, commonly disease duration 4\u20138\u2009years or onset of motor complications without significant disability. We included\n RCTs<\/jats:styled-content>\n , secondary analyses, observational studies, and unpublished trials; meta\u2010analyses were restricted to randomized comparisons of early\n DBS<\/jats:styled-content>\n plus\n BMT<\/jats:styled-content>\n versus\n BMT<\/jats:styled-content>\n alone.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Studies included younger patients with \u22648\u2009years\u2019\n PD<\/jats:styled-content>\n duration and early motor complications. Pooled\n RCT<\/jats:styled-content>\n data showed a consistent quality\u2010of\u2010life benefit, while motor and medication outcomes directionally favored early\n STN<\/jats:styled-content>\n \u2010\n DBS<\/jats:styled-content>\n but remained heterogeneous and imprecise. Studies suggest safety is broadly comparable to standard\u2010indication\n DBS.<\/jats:styled-content>\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Offering\n DBS<\/jats:styled-content>\n before advanced disability\u2014particularly in patients <60\u2009years, <10\u2009years from diagnosis, Hoehn\u2013Yahr stage \u22643, early motor complications, and no dementia\u2014may help delay loss of quality of life versus\n BMT<\/jats:styled-content>\n alone. Given few trials and substantial heterogeneity, further large\u2010scale randomized studies are needed to confirm safety, define optimal timing in early\n PD<\/jats:styled-content>\n , and clarify which subgroups benefit most.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mdc3.70666","type":"journal-article","created":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T06:50:03Z","timestamp":1777704603000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Early Deep Brain Stimulation for Parkinson's Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1191-0678","authenticated-orcid":false,"given":"Jose P.","family":"Araya","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hospital Dr. Hern\u00e1n Henr\u00edquez Aravena Universidad de La Frontera Temuco Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6656-7687","authenticated-orcid":false,"given":"Honglin","family":"Zhu","sequence":"additional","affiliation":[{"name":"MBBS Program King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0958-050X","authenticated-orcid":false,"given":"William","family":"Anderson","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine Department of Neurosurgery Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2181-9029","authenticated-orcid":false,"given":"Mart\u00edn","family":"Merenzon","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine Department of Neurosurgery Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7871-5547","authenticated-orcid":false,"given":"Camila F.","family":"Castillo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Dr. Hern\u00e1n Henr\u00edquez Aravena Universidad de La Frontera Temuco Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma A.","family":"Escalante","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Dr. Hern\u00e1n Henr\u00edquez Aravena Universidad de La Frontera Temuco Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosita L.","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Dr. Hern\u00e1n Henr\u00edquez Aravena Universidad de La Frontera Temuco Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756285609339382"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20962"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23890"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/9781119536604","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","author":"Higgins J","year":"2019"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2014.03.019"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1205158"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000250253.03919.fb"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurom.2022.10.051"},{"key":"e_1_2_9_12_1","unstructured":"Juntendo Early Deep Brain Stimulation Trial (JuST) (UMIN000009229). Juntendo University; 2012. Located at: Clinical trial Registration; WHO ICTRP."},{"key":"e_1_2_9_13_1","unstructured":"LingC.Early Versus Late Application of STN DBS to PD Patients With Motor Complications (ELASS). ClinicalTrials.Gov; 2023. Located at: NCT01922388;https:\/\/clinicaltrials.gov\/study\/NCT01922388?term=elass&rank=1."},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-018610"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007037"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2021.106976"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0159340"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30035-8"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.3171\/2013.10.JNS131225"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29282"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25047"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awq221"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26688"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2020.00492"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2023.105479"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2014.10.031"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2019.10.008"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12740"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2009.05.004"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci12060766"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.11.JNS16715"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S105505"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.4.JNS131711"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.2060-16.2017"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2024.114684"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41531-024-00668-4"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29052"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70666","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mdc3.70666","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70666","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T06:50:05Z","timestamp":1777704605000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.70666"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":36,"alternative-id":["10.1002\/mdc3.70666"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.70666","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,1]]},"assertion":[{"value":"2025-10-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"mdc3.70666"}}