{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:54:19Z","timestamp":1791269659019,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"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 Disorders"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adaptive deep brain stimulation (aDBS) is a safe and effective therapy for people with Parkinson's disease (PWP). Utilization of directional aDBS has not been specifically evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The goal is to report the first data on the safety, tolerability, and preliminary effectiveness of chronic, directional aDBS in PWP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A supplemental cohort from the Adaptive DBS Algorithm for Personalized Therapy in Parkinson's Disease Trial received directional aDBS. Participants who were previously receiving stable continuous directional DBS (dDBS) completed an open\u2010label evaluation of two aDBS modes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventeen participants were enrolled, with 15 completing directional aDBS evaluation. The prespecified primary endpoint and post hoc success criterion was met for both directional aDBS modes. On\u2010time without troublesome dyskinesia was increased, with a median of 1.2\u2009hours\/day in directional dual threshold aDBS mode. Stimulation\u2010related events were similar between dDBS and directional aDBS. All 15 participants chose to continue with directional aDBS chronically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Preliminary data indicates chronic directional aDBS is feasible, tolerable, effective, and safe in PWP. \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                  <\/jats:sec>","DOI":"10.1002\/mds.70556","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:36:32Z","timestamp":1791268592000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Directional Adaptive Deep Brain Stimulation: An Initial Report of Safety, Tolerability, and Effectiveness"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2488-7051","authenticated-orcid":false,"given":"Martijn","family":"Beudel","sequence":"first","affiliation":[{"name":"Department of Neurology Amsterdam University Medical Centers  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9489-7418","authenticated-orcid":false,"given":"Todd M.","family":"Herrington","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6249-6230","authenticated-orcid":false,"given":"Simon","family":"Little","sequence":"additional","affiliation":[{"name":"Department of Neurology, Movement Disorder and Neuromodulation Center, Weill Neuroscience Institute University of California San Francisco  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7018-9521","authenticated-orcid":false,"given":"Jill L.","family":"Ostrem","sequence":"additional","affiliation":[{"name":"Department of Neurology, Movement Disorder and Neuromodulation Center, Weill Neuroscience Institute University of California San Francisco  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0921-887X","authenticated-orcid":false,"given":"Leonardo","family":"Almeida","sequence":"additional","affiliation":[{"name":"Department of Neurology, Norman Fixel Institute for Neurological Diseases University of Florida  Gainsville FL USA"},{"name":"Department of Neurology University of Minnesota  Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9253-3899","authenticated-orcid":false,"given":"Adolfo","family":"Ramirez\u2010Zamora","sequence":"additional","affiliation":[{"name":"Department of Neurology, Norman Fixel Institute for Neurological Diseases University of Florida  Gainsville FL USA"},{"name":"Department of Neurology University of Louisville  Louisville KY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5346-0180","authenticated-orcid":false,"given":"Alfonso","family":"Fasano","sequence":"additional","affiliation":[{"name":"Edmond J. Safra Program in Parkinson's Disease, Division of Neurology, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN University of Toronto  Toronto Canada"},{"name":"Krembil Brain Institute, University of Toronto  Toronto Canada"},{"name":"Department of Biomedical Sciences Humanitas University  Milan Italy"},{"name":"IRCCS Humanitas Research Hospital  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9617-6670","authenticated-orcid":false,"given":"Travis","family":"Hassell","sequence":"additional","affiliation":[{"name":"Department of Neurology Vanderbilt University Medical Center  Nashville TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4788-1581","authenticated-orcid":false,"given":"Kyle T.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Duke University Movement Disorders Center Duke University  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7968-5908","authenticated-orcid":false,"given":"Elena","family":"Moro","sequence":"additional","affiliation":[{"name":"Division of Neurology, CHU of Grenoble, Grenoble Institute of Neuroscience, CHU of Grenoble Grenoble Alpes University  Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Gostkowski","sequence":"additional","affiliation":[{"name":"Center for Neurological Restoration Cleveland Clinic Foundation  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Stanslaski","sequence":"additional","affiliation":[{"name":"Medtronic Neuromodulation, Medtronic  Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1783-3362","authenticated-orcid":false,"given":"Rebekah 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