{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T02:24:08Z","timestamp":1790043848871,"version":"4.0.1"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>\n<jats:styled-content>Abstract<\/jats:styled-content>\n<\/jats:title><jats:sec><jats:title>\n<jats:styled-content>Background<\/jats:styled-content>\n<\/jats:title><jats:p>\n<jats:styled-content>The efficacy of subthalamic stimulation on axial signs of Parkinson's disease (PD) is debated in the literature. This study delves into the dynamic interplay of gait and posture, specifically probing their nuanced response to subthalamic stimulation and levodopa.<\/jats:styled-content>\n<\/jats:p><\/jats:sec><jats:sec><jats:title>\n<jats:styled-content>Methods<\/jats:styled-content>\n<\/jats:title><jats:p>\n<jats:styled-content>We used wearable sensor technology to examine alterations in the spatiotemporal parameters of gait and posture in individuals with PD before and 6 months after subthalamic deep brain stimulation (STN\u2010DBS) surgery. Thirty\u2010three subjects with PD were evaluated in two pre\u2010operative and four post\u2010operative conditions comprising OFF\/ON medication and stimulation states. Standardized response mean (SRM) values were calculated to assess treatment responsiveness.<\/jats:styled-content>\n<\/jats:p><\/jats:sec><jats:sec><jats:title>\n<jats:styled-content>Results<\/jats:styled-content>\n<\/jats:title><jats:p>\n<jats:styled-content>Significant improvements in spatiotemporal gait parameters, including speed, stride length, cadence, and turning, were observed following STN\u2010DBS surgery. Quantitatively, stimulation outperformed levodopa in enhancing gait speed, stride length, and turning, as indicated by SRM. Levodopa moderately improved stride time variability and asymmetry, while stimulation alone demonstrated limited efficacy. Postural parameters exhibited minimal change following STN\u2010DBS, although stimulation showed a slight benefit in certain postural aspects.<\/jats:styled-content>\n<\/jats:p><\/jats:sec><jats:sec><jats:title>\n<jats:styled-content>Conclusion<\/jats:styled-content>\n<\/jats:title><jats:p>\n<jats:styled-content>Our findings suggest positive effects of stimulation and levodopa on gait and postural parameters, with STN\u2010DBS demonstrating superior efficacy in enhancing gait speed, stride length, and turning. However, gait variability remains unaddressed by current therapies, highlighting the need for novel treatments targeting regions beyond the basal ganglia.<\/jats:styled-content>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16580","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T03:39:36Z","timestamp":1734665976000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Evaluating gait and postural responses to subthalamic stimulation and levodopa: A prospective study using wearable technology"],"prefix":"10.1111","volume":"32","author":[{"given":"Ilaria","family":"Cani","sequence":"first","affiliation":[{"name":"UOC Clinica Neurologica Rete Metropolitana NEUROMET IRCCS Istituto delle Scienze Neurologiche di Bologna  Bologna Italy"},{"name":"Department of Biomedical and NeuroMotor Sciences (DIBINEM) Alma Mater Studiorum \u2013 University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"D'Ascanio","sequence":"additional","affiliation":[{"name":"Department of Electrical, Electronic, and Information Engineering Alma Mater Studiorum \u2013 University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Baldelli","sequence":"additional","affiliation":[{"name":"UOC Clinica Neurologica Rete Metropolitana NEUROMET IRCCS Istituto delle Scienze Neurologiche di Bologna  Bologna Italy"},{"name":"Department of Biomedical and NeuroMotor Sciences (DIBINEM) Alma Mater Studiorum \u2013 University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Lopane","sequence":"additional","affiliation":[{"name":"Unit of Rehabilitation Medicine IRCCS Istituto delle Scienze Neurologiche di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saverio","family":"Ranciati","sequence":"additional","affiliation":[{"name":"Department of Statistical Science \"Paolo Fortunati\" University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Mantovani","sequence":"additional","affiliation":[{"name":"Unit of Neurosurgery IRCCS Istituto delle Scienze Neurologiche di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Conti","sequence":"additional","affiliation":[{"name":"Department of Biomedical and NeuroMotor Sciences (DIBINEM) Alma Mater Studiorum \u2013 University of Bologna  Bologna Italy"},{"name":"Unit of Neurosurgery IRCCS Istituto delle Scienze Neurologiche di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3633-8818","authenticated-orcid":false,"given":"Pietro","family":"Cortelli","sequence":"additional","affiliation":[{"name":"UOC Clinica Neurologica Rete Metropolitana NEUROMET IRCCS Istituto delle Scienze Neurologiche di Bologna  Bologna Italy"},{"name":"Department of Biomedical and NeuroMotor Sciences (DIBINEM) Alma Mater Studiorum \u2013 University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Calandra\u2010Buonaura","sequence":"additional","affiliation":[{"name":"UOC Clinica Neurologica Rete Metropolitana NEUROMET IRCCS Istituto delle Scienze Neurologiche di Bologna  Bologna Italy"},{"name":"Department of Biomedical and NeuroMotor Sciences (DIBINEM) Alma Mater Studiorum \u2013 University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Chiari","sequence":"additional","affiliation":[{"name":"Department of Electrical, Electronic, and Information Engineering Alma Mater Studiorum \u2013 University of Bologna  Bologna Italy"},{"name":"Health Sciences and Technologies \u2010 Interdepartmental Center for Industrial Research (CIRI\u2010SDV) Alma Mater Studiorum \u2010 University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Palmerini","sequence":"additional","affiliation":[{"name":"Department of Electrical, Electronic, and Information Engineering Alma Mater Studiorum \u2013 University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0499-3236","authenticated-orcid":false,"given":"Giulia","family":"Giannini","sequence":"additional","affiliation":[{"name":"UOC Clinica Neurologica Rete Metropolitana NEUROMET IRCCS Istituto delle Scienze Neurologiche di Bologna  Bologna Italy"},{"name":"Department of Biomedical and NeuroMotor Sciences (DIBINEM) Alma Mater Studiorum \u2013 University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-019-0145-9"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22340"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa060281"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30108-3"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2012.10.025"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2014.252"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.1222"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-023-11780-5"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/124.8.1590"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-004-2036-5"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.60.1.80"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/s20123529"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30044-4"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(91)90283-D"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26269"},{"key":"e_1_2_13_17_1","doi-asserted-by":"crossref","unstructured":"LeirasRet\u00a0al.Annual Review of Neuroscience Brainstem Circuits for Locomotion.2022. doi:10.1146\/annurev-neuro-082321","DOI":"10.1146\/annurev-neuro-082321-025137"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20115"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10149"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26424"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1227\/ons.0000000000001151"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25383"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(11)70143-0"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-200112000-00005"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-202262"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/87565649109540545"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12921"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12987-022-00350-y"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.conctc.2021.100817"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12984-019-0638-1"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurom.2022.01.015"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.86.2.420"},{"key":"e_1_2_13_33_1","volume-title":"The Design and Analysis of Clinical Experiments","author":"Fleiss JL","year":"1986"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27195"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/141720"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-005-0310-8"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.4103\/aian.aian_769_22"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.57.1.144"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004150170027"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25674"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/1353-8020(95)00008-9"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.73.3.267"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-005-0202-z"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2011.11.005"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awg100"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25628"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.birob.2023.100089"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1109\/TNSRE.2012.2236577"},{"key":"e_1_2_13_49_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0183989"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.3390\/s23083902"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12984-020-00774-3"},{"key":"e_1_2_13_52_1","doi-asserted-by":"publisher","DOI":"10.1109\/IEMBS.2011.6091605"},{"key":"e_1_2_13_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2018.09.015"},{"key":"e_1_2_13_54_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24778"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.16580","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T05:12:27Z","timestamp":1737954747000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.16580"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,19]]},"references-count":53,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1111\/ene.16580"],"URL":"https:\/\/doi.org\/10.1111\/ene.16580","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,19]]},"assertion":[{"value":"2024-07-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e16580"}}