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Twenty\u2010minute sessions of tDCS and sham were administered on 2\u2009days in randomized order. Movement Disorder Society\u2010Unified Parkinson's Disease Rating Scale\u2014Part III (MDS\u2010UPDRS\u2010III) scores were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Before intervention, MDS\u2010UPDRS\u2010III scores were comparable in both conditions (stimulation days: 37.38 (standard deviation [SD]\u2009=\u200912.50, confidence interval [CI]\u2009=\u200932.04, 42.73) vs. sham days: 36.95 (SD\u2009=\u200913.94, CI\u2009=\u200930.99, 42.91), <jats:italic>P<\/jats:italic>\u2009=\u20090.63). Active stimulation resulted in a reduction by 3.6 points (9.7%) to 33.76 (SD\u2009=\u200911.19, CI\u2009=\u200928.98, 38.55) points, whereas no relevant change was observed after sham stimulation (36.43 [SD\u2009=\u200914.15, CI\u2009=\u200930.38, 42.48], average improvement: 0.5 [1.4%]). Repeated\u2010measures analysis of variance (ANOVA) confirmed significance (main effect of time: F<jats:sub>(1,20)<\/jats:sub>=4.35, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Tukey's post hoc tests indicated MDS\u2010UPDRS\u2010III improvement after active stimulation (<jats:italic>t<\/jats:italic> [20]\u2009=\u20092.9, <jats:italic>P<\/jats:italic>\u2009=\u20090.03) but not after sham (<jats:italic>t<\/jats:italic> [20]\u2009=\u20090.42, <jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). In a subset of patients that underwent DBS surgery later, their DBS response correlated with tDCS effects (<jats:italic>R<\/jats:italic>\u2009=\u20090.55, <jats:italic>P<\/jats:italic><jats:sub>(1)<\/jats:sub>\u2009=\u20090.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Noninvasive, multifocal tDCS targeting a DBS\u2010derived network significantly improved PD motor symptoms. Despite a small effect size, this study provides proof of principle for the successful noninvasive neuromodulation of an invasively identified network. Future studies should investigate repeated tDCS sessions and their utility for screening before DBS surgery. \u00a9 2024 The Author(s). <jats:italic>Movement Disorders<\/jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.29940","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T07:40:08Z","timestamp":1721893208000},"page":"1971-1981","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Linking Invasive and Noninvasive Brain Stimulation in Parkinson's Disease: A Randomized Trial"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6026-185X","authenticated-orcid":false,"given":"Lukas L.","family":"Goede","sequence":"first","affiliation":[{"name":"Department of Neurology with Experimental Neurology, Charit\u00e9\u2010Universit\u00e4tsmedizin 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