{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:55:23Z","timestamp":1790848523443,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n \n Individuals with Parkinson's disease (PD) carrying\n GBA1<\/jats:italic>\n variants often develop advanced motor complications that prompt evaluation for deep brain stimulation (DBS). However, concerns about accelerated cognitive decline after DBS in\n GBA1<\/jats:italic>\n carriers complicate clinical decision making. A critical aspect that is increasingly gaining attention is the time at which DBS is performed.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n The objective is to determine how the timing of DBS in relation to PD onset impacts cognitive trajectories across different\n GBA1<\/jats:italic>\n variant classes and in individuals without\n GBA1<\/jats:italic>\n variants.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A multicenter cohort study across 10 study sites in Europe and the USA was conducted. The study population comprised subjects with (\n \n GBA1<\/jats:italic>\n <\/jats:styled-content>\n \u2010Associated Parkinson's Disease [GBA\u2010PD]) and without\n GBA1<\/jats:italic>\n variants (nonGBA\u2010PD), who were subjected to bilateral subthalamic nucleus (STN)\u2010DBS. The main outcome measure was the Mattis Dementia Rating Scale (MDRS).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 343 individuals (91 GBA\u2010PD and 252 nonGBA\u2010PD) were included in this study. Percentile\u2010based stratification into early and late STN\u2010DBS treatment groups and linear mixed model analyses revealed that GBA\u2010PD patients in the late DBS group had a significantly faster rate of cognitive decline independent of age, with sensitivity analyses identifying the 7\u2010 and 8\u2010year cutoffs as the time points with a significant difference between early and late STN\u2010DBS groups in GBA\u2010PD. A negative correlation between MDRS scores and time from disease onset to STN\u2010DBS was observed in GBA\u2010PD, and was not present in nonGBA\u2010PD. Cognitive trajectories were markedly worse in GBA\u2010PD compared to nonGBA\u2010PD, and this pattern was not influenced by the variant type.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In GBA\u2010PD, STN\u2010DBS treatment at later stages is associated with greater risk of cognitive decline. Earlier STN\u2010DBS intervention in GBA\u2010PD may extend the period of improved motor function before the onset of significant cognitive decline. These findings highlight the potential importance of early genetic testing and disease duration when considering STN\u2010DBS in genetically defined PD populations. \u00a9 2026 The Author(s).\n Movement Disorders<\/jats:italic>\n published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/mds.70520","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:10:38Z","timestamp":1790845838000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Timing of Deep Brain Stimulation and Cognitive Trajectories in\n \n GBA1<\/i>\n <\/scp>\n \u2010Associated Parkinson's Disease"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0902-1054","authenticated-orcid":false,"given":"Evridiki","family":"Asimakidou","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences University of Cambridge Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7880-9921","authenticated-orcid":false,"given":"Micol","family":"Avenali","sequence":"additional","affiliation":[{"name":"Department of Brain and Behavioural Sciences University of Pavia Pavia Italy"},{"name":"IRCCS Mondino Foundation Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0558-7686","authenticated-orcid":false,"given":"Jan O.","family":"Aasly","sequence":"additional","affiliation":[{"name":"Department of Neurology St. Olavs Hospital Trondheim Norway"},{"name":"Department of Neuroscience Norwegian University of Science and Technology Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4803-953X","authenticated-orcid":false,"given":"Mitra","family":"Afshari","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation University of Illinois at Chicago Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5717-4875","authenticated-orcid":false,"given":"Roy N.","family":"Alcalay","sequence":"additional","affiliation":[{"name":"Department of Neurology College of Physicians and Surgeons, Columbia University Medical Center New York New York USA"},{"name":"Tel Aviv Sourasky Medical Center Tel Aviv Israel"},{"name":"Gray Faculty of Medical & Health Sciences Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharlet","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Neurology Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo Alberto","family":"Artusi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Biomedicine and Movement Sciences University of Verona, AOUI Verona Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Bernard","sequence":"additional","affiliation":[{"name":"Department of Neurology Rush University Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8218-0708","authenticated-orcid":false,"given":"Marco","family":"Bozzali","sequence":"additional","affiliation":[{"name":"Department of Neuroscience \u201cRita Levi Montalcini\u201d University of Torino Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3513-8048","authenticated-orcid":false,"given":"Susan","family":"Bressman","sequence":"additional","affiliation":[{"name":"Department of Neurology Mount Sinai\/Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9447-3532","authenticated-orcid":false,"given":"Giovanna","family":"Calandra\u2010Buonaura","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy"},{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5836-1982","authenticated-orcid":false,"given":"Francesco","family":"Cavallieri","sequence":"additional","affiliation":[{"name":"Neurology Unit, Neuromotor & Rehabilitation Department Azienda USL\u2010IRCCS of Reggio Emilia Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1990-1939","authenticated-orcid":false,"given":"Roberto","family":"Cilia","sequence":"additional","affiliation":[{"name":"SC Neurologia 1, Fondazione IRCCS Istituto Neurologico C. 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