{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T07:48:58Z","timestamp":1791791338501,"version":"4.3.4"},"reference-count":41,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100016304","name":"Medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016304","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Freezing of gait (FoG) belongs to most pressing unmet symptoms in the treatment of Parkinson's disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore whether combined subthalamic and nigral (STN\u2009+\u2009SNr) deep brain stimulation improves FoG compared with optimized STN stimulation alone; to identify clinical variables associated with therapeutic response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this exploratory multicenter randomized controlled double\u2010blind trial, we recruited patients from our existing cohorts and randomized them 1:1 to\n                      <jats:styled-content style=\"fixed-case\">STN<\/jats:styled-content>\n                      or\n                      <jats:styled-content style=\"fixed-case\">STN<\/jats:styled-content>\n                      \u2009+\u2009\n                      <jats:styled-content style=\"fixed-case\">SNr<\/jats:styled-content>\n                      . After baseline, patients were followed with close interim visits (visits 1\u20135) for 90\u2009days (visit 6). The Freezing of Gait Assessment Course (\n                      <jats:styled-content style=\"fixed-case\">FoG<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>\n                      ) was the primary endpoint and was evaluated at\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.2 with exploratory intent. Secondary endpoints assessed responder rates, treatment dynamics, predictors of response, and patient preferences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At V6, STN (n\u2009=\u200923) and STN\u2009+\u2009SNr (n\u2009=\u200922) FoG\u2010AC outcomes did not differ significantly. We identified responders with clinically meaningful FoG improvement in both the STN (n\u2009=\u20097) and STN\u2009+\u2009SNr (n\u2009=\u20098) groups. In STN\u2009+\u2009SNr responders, mean disease duration was ~12\u2009years, which was ~4.5\u2009years shorter than in non\u2010responders, but there were no differences in motor and cognitive functions. Treatment dynamics suggested that FoG responders improved slowly and gradually. The STN\u2009+\u2009SNr responder group showed numerically stronger FoG improvement compared with STN responders. Additionally, 15 STN compared to 10 STN\u2009+\u2009SNr patients wished to change treatment after the RCT phase and before unblinding. Both STN and STN\u2009+\u2009SNr treatment was safe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Future trials evaluating adjunctive STN\u2009+\u2009SNr stimulation should stratify patients by disease duration to optimize outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70813","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T07:27:16Z","timestamp":1791790036000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disease Duration Differentiates Freezing of Gait Response to Subthalamic and Nigral Stimulation for Parkinson's Disease in an Exploratory Multicenter Controlled 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Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Kolber","sequence":"additional","affiliation":[{"name":"Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg; and Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch\u2010sur\u2010Alzette, Luxembourg; and Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg  Esch\u2010sur\u2010Alzette Luxembourg"},{"name":"Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg  Esch\u2010sur\u2010Alzette Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7680-2147","authenticated-orcid":false,"given":"Monika","family":"P\u00f6tter\u2010Nerger","sequence":"additional","affiliation":[{"name":"Department of Neurology, and Neurosurgery University Medical Center Hamburg\u2010Eppendorf  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