{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T20:24:55Z","timestamp":1787603095164,"version":"build-2736575974"},"reference-count":32,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":146,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Parkinsonism & Related Disorders"],"published-print":{"date-parts":[[2026]]},"DOI":"10.1016\/j.prdoa.2026.100458","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T15:28:43Z","timestamp":1780586923000},"page":"100458","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"special_numbering":"C","title":["Timing of device-aided therapy initiation in Parkinson's disease: reference estimates for healthcare planning and biological heterogeneity"],"prefix":"10.1016","volume":"14","author":[{"given":"David","family":"Ledingham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte B.","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahana","family":"Sathyanarayana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Foster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Iredale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Galley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark R.","family":"Baker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Pavese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"n\/a","key":"10.1016\/j.prdoa.2026.100458_bb0005","article-title":"Motor complications in Parkinson\u2019s disease: results from 3343 patients followed for up to 12years","volume":"n\/a","author":"Gandhi","year":"2024","journal-title":"Mov. Disord. Clin. Pract."},{"issue":"10","key":"10.1016\/j.prdoa.2026.100458_bb0010","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1002\/mdc3.13845","article-title":"The clinical profile of tremor in Parkinson\u2019s disease","volume":"10","author":"Pasquini","year":"2023","journal-title":"Movement Disorders Clin. Pract."},{"issue":"5","key":"10.1016\/j.prdoa.2026.100458_bb0015","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1002\/mds.30162","article-title":"Update on treatments for Parkinson\u2019s disease motor fluctuations \u2013 an International Parkinson and movement disorder society evidence-based medicine review","volume":"40","author":"de Bie","year":"2025","journal-title":"Mov. Disord."},{"issue":"1","key":"10.1016\/j.prdoa.2026.100458_bb0020","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1080\/17582024.2025.2546754","article-title":"Tremor management strategies in Parkinson\u2019s disease: optimizing patient care","volume":"16","author":"Pavese","year":"2026","journal-title":"Neurodegener Dis. Manag."},{"issue":"1","key":"10.1016\/j.prdoa.2026.100458_bb0025","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s12883-019-1276-8","article-title":"Characterizing advanced Parkinson\u2019s disease: OBSERVE-PD observational study results of 2615 patients","volume":"19","author":"Fasano","year":"2019","journal-title":"BMC Neurol."},{"issue":"12","key":"10.1016\/j.prdoa.2026.100458_bb0030","doi-asserted-by":"crossref","DOI":"10.3390\/brainsci11121557","article-title":"Prevalence of advanced Parkinson\u2019s disease in patients treated in the hospitals of the Spanish National Healthcare System: the PARADISE study","volume":"11","author":"Mart\u00ednez-Castrillo","year":"2021","journal-title":"Brain Sci."},{"issue":"12","key":"10.1016\/j.prdoa.2026.100458_bb0035","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.1080\/03007995.2018.1502165","article-title":"Developing consensus among movement disorder specialists on clinical indicators for identification and management of advanced Parkinson\u2019s disease: a multi-country Delphi-panel approach","volume":"34","author":"Antonini","year":"2018","journal-title":"Curr. Med. Res. Opin."},{"issue":"1","key":"10.1016\/j.prdoa.2026.100458_bb0040","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s12883-022-02560-1","article-title":"Does the 5-2-1 criteria identify patients with advanced Parkinson\u2019s disease? Real-world screening accuracy and burden of 5-2-1-positive patients in 7 countries","volume":"22","author":"Malaty","year":"2022","journal-title":"BMC Neurol."},{"issue":"5","key":"10.1016\/j.prdoa.2026.100458_bb0045","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1002\/acn3.70188","article-title":"Tracking motor progression and device-aided therapy eligibility in Parkinson\u2019s disease","volume":"13","author":"Ledingham","year":"2026","journal-title":"Ann. Clin. Transl. Neurol."},{"issue":"6","key":"10.1016\/j.prdoa.2026.100458_bb0050","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1002\/mdc3.13747","article-title":"Predictors of future deep brain stimulation surgery in de novo Parkinson\u2019s disease","volume":"10","author":"Lang","year":"2023","journal-title":"Mov. Disord. Clin. Pract."},{"issue":"5","key":"10.1016\/j.prdoa.2026.100458_bb0055","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/S1474-4422(23)00109-6","article-title":"Assessment of heterogeneity among participants in the Parkinson\u2019s progression markers initiative cohort using \u03b1-synuclein seed amplification: a cross-sectional study","volume":"22","author":"Siderowf","year":"2023","journal-title":"Lancet Neurol."},{"issue":"2","key":"10.1016\/j.prdoa.2026.100458_bb0060","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/S1474-4422(23)00405-2","article-title":"A biological definition of neuronal \u03b1-synuclein disease: towards an integrated staging system for research","volume":"23","author":"Simuni","year":"2024","journal-title":"Lancet Neurol."},{"issue":"4","key":"10.1016\/j.prdoa.2026.100458_bb0065","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.pneurobio.2011.09.005","article-title":"The Parkinson progression marker initiative (PPMI)","volume":"95","year":"2011","journal-title":"Prog. Neurobiol."},{"issue":"12","key":"10.1016\/j.prdoa.2026.100458_bb0070","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1002\/acn3.644","article-title":"The Parkinson\u2019s progression markers initiative (PPMI) - establishing a PD biomarker cohort","volume":"5","author":"Marek","year":"2018","journal-title":"Ann. Clin. Transl. Neurol."},{"issue":"3","key":"10.1016\/j.prdoa.2026.100458_bb0075","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1002\/mds.29314","article-title":"Classification of GBA1 variants in Parkinson\u2019s disease: the GBA1-PD browser","volume":"38","author":"Parlar","year":"2023","journal-title":"Mov. Disord."},{"issue":"4","key":"10.1016\/j.prdoa.2026.100458_bb0080","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1002\/mds.30141","article-title":"Classification and genotype\u2013phenotype relationships of GBA1 variants: MDSGene systematic review","volume":"40","author":"Rossi","year":"2025","journal-title":"Mov. Disord."},{"issue":"1","key":"10.1016\/j.prdoa.2026.100458_bb0085","article-title":"Updated MDSGene review on the clinical and genetic spectrum of LRRK2 variants in Parkinson\u2019s disease","volume":"11","author":"Kr\u00fcger","year":"2025","journal-title":"NPJ Parkinson\u2019s Dis."},{"issue":"12","key":"10.1016\/j.prdoa.2026.100458_bb0090","doi-asserted-by":"crossref","first-page":"1857","DOI":"10.1002\/mds.27527","article-title":"Genotype-phenotype relations for the Parkinson\u2019s disease genes SNCA, LRRK2, VPS35: MDSGene systematic review","volume":"33","author":"Trinh","year":"2018","journal-title":"Mov. Disord."},{"issue":"5","key":"10.1016\/j.prdoa.2026.100458_bb0095","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1002\/mds.25383","article-title":"How to identify tremor dominant and postural instability\/gait difficulty groups with the movement disorder society unified Parkinson\u2019s disease rating scale: comparison with the unified Parkinson\u2019s disease rating scale","volume":"28","author":"Stebbins","year":"2013","journal-title":"Mov. Disord."},{"issue":"9","key":"10.1016\/j.prdoa.2026.100458_bb0100","doi-asserted-by":"crossref","first-page":"1904","DOI":"10.1002\/mds.29154","article-title":"Dissecting the domains of Parkinson\u2019s disease: insights from longitudinal item response theory modeling","volume":"37","author":"Luo","year":"2022","journal-title":"Mov. Disord."},{"issue":"1","key":"10.1016\/j.prdoa.2026.100458_bb0105","doi-asserted-by":"crossref","DOI":"10.1038\/s41531-022-00320-z","article-title":"Parkinson\u2019s disease clinical milestones and mortality","volume":"8","author":"Gonzalez","year":"2022","journal-title":"NPJ Parkinsons Dis."},{"issue":"8","key":"10.1016\/j.prdoa.2026.100458_bb0110","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1002\/acn3.51102","article-title":"Parkinson disease clinical subtypes: key features & clinical milestones","volume":"7","author":"Campbell","year":"2020","journal-title":"Ann. Clin. Transl. Neurol."},{"issue":"4","key":"10.1016\/j.prdoa.2026.100458_bb0115","doi-asserted-by":"crossref","first-page":"e393","DOI":"10.1212\/WNL.0000000000009946","article-title":"Deep brain stimulation in early-stage Parkinson disease","volume":"95","author":"Hacker","year":"2020","journal-title":"Neurology"},{"key":"10.1016\/j.prdoa.2026.100458_bb0120","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.parkreldis.2021.10.009","article-title":"Validation and clinical value of the MANAGE-PD tool: a clinician-reported tool to identify Parkinson\u2019s disease patients inadequately controlled on oral medications","volume":"92","author":"Antonini","year":"2021","journal-title":"Parkinsonism Relat. Disord."},{"issue":"11","key":"10.1016\/j.prdoa.2026.100458_bb0125","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1007\/s00702-023-02668-9","article-title":"Access to device-aided therapies in advanced Parkinson\u2019s disease: navigating clinician biases, patient preference, and prognostic uncertainty","volume":"130","author":"Auffret","year":"2023","journal-title":"J. Neural Transm. (Vienna)"},{"key":"10.1016\/j.prdoa.2026.100458_bb0130","doi-asserted-by":"crossref","DOI":"10.1016\/j.parkreldis.2023.105921","article-title":"Long-term follow-up of subthalamic nucleus deep brain stimulation in patients with Parkinson\u2019s disease: an analysis of survival and disability milestones","volume":"118","author":"Barbosa","year":"2024","journal-title":"Parkinsonism Relat. Disord."},{"issue":"7","key":"10.1016\/j.prdoa.2026.100458_bb0135","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1002\/mdc3.13039","article-title":"Has deep brain stimulation changed the very long-term outcome of Parkinson\u2019s disease? A controlled longitudinal study","volume":"7","author":"Mahlknecht","year":"2020","journal-title":"Mov. Disord. Clin. Pract."},{"issue":"6","key":"10.1016\/j.prdoa.2026.100458_bb0140","doi-asserted-by":"crossref","first-page":"1996","DOI":"10.1093\/brain\/awae073","article-title":"Genetic analysis and natural history of Parkinson\u2019s disease due to the LRRK2 G2019S variant","volume":"147","author":"Kmiecik","year":"2024","journal-title":"Brain"},{"key":"10.1016\/j.prdoa.2026.100458_bb0145","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.parkreldis.2020.04.002","article-title":"Early cognitive decline after bilateral subthalamic deep brain stimulation in Parkinson\u2019s disease patients with GBA mutations","volume":"76","author":"Mangone","year":"2020","journal-title":"Parkinsonism Relat. Disord."},{"issue":"5","key":"10.1016\/j.prdoa.2026.100458_bb0150","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1002\/mdc3.13994","article-title":"Motor and non-motor outcomes of deep brain stimulation across the genetic panorama of Parkinson\u2019s disease: a multi-scale meta-analysis","volume":"11","author":"Asimakidou","year":"2024","journal-title":"Mov. Disord. Clin. Pract."},{"issue":"2","key":"10.1016\/j.prdoa.2026.100458_bb0155","doi-asserted-by":"crossref","DOI":"10.1093\/braincomms\/fcaf103","article-title":"LRRK2-associated parkinsonism with and without in vivo evidence of alpha-synuclein aggregates: longitudinal clinical and biomarker characterization","volume":"7","author":"Chahine","year":"2025","journal-title":"Brain Commun."},{"issue":"5","key":"10.1016\/j.prdoa.2026.100458_bb0160","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1002\/mds.70197","article-title":"Clinical and imaging characteristics of Parkinson\u2019s disease with negative alpha-Synuclein seed amplification assay","volume":"41","author":"Brooker","year":"2026","journal-title":"Mov. Disord."}],"updated-by":[{"DOI":"10.1016\/j.prdoa.2026.100495","type":"erratum","label":"Erratum","source":"publisher","updated":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000}}],"container-title":["Clinical Parkinsonism & Related Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2590112526000381?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2590112526000381?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T08:16:42Z","timestamp":1783930602000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2590112526000381"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":32,"alternative-id":["S2590112526000381"],"URL":"https:\/\/doi.org\/10.1016\/j.prdoa.2026.100458","relation":{},"ISSN":["2590-1125"],"issn-type":[{"value":"2590-1125","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Timing of device-aided therapy initiation in Parkinson's disease: reference estimates for healthcare planning and biological heterogeneity","name":"articletitle","label":"Article Title"},{"value":"Clinical Parkinsonism & Related Disorders","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.prdoa.2026.100458","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"100458"}}