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Comprehensive clinical and magnetic resonance imaging (MRI) assessments were administered at baseline, 1 day, and 1 month post\u2010stimulation for both conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Manual dexterity, measured via the coin rotation task, showed significantly larger improvement following verum compared with sham TPS (post\u2010stimulation vs. baseline:\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>corr<\/jats:sub>\n                      \u2009=\u20090.048, \u03b7p\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.14; 1\u2010month post\u2010stimulation vs. baseline:\n                      <jats:italic>P<\/jats:italic>\n                      <jats:sub>corr<\/jats:sub>\n                      \u2009=\u20090.048, \u03b7p\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.17). Gross motor symptoms, evaluated by the Movement Disorder Society\u2010Unified Parkinson's Disease Rating Scale\u2010Part III (MDS\u2010UPDRS\u2010III), improved similarly after both verum and sham TPS. Functional MRI during a coin rotation task revealed increased activation in the sensorimotor network following verum stimulation compared with sham (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Diffusion tensor imaging data indicated enhanced structural integrity in the primary somatosensory white matter following verum TPS compared with sham (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05 family\u2010wise error [FWE]\u2010corrected). A total of 21 adverse events were reported, all mild and transient.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      These findings indicate that TPS produces behavioral, neurophysiological, and structural effects within the targeted sensorimotor network, and may represent a safe and effective adjunct to standard therapies in PD. \u00a9 2026 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n                    <\/jats:p>\n                  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