{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:46:52Z","timestamp":1790221612494,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Parkinson's disease (PD) affects both motor and non\u2010motor functions, including facial expressivity. While subthalamic nucleus deep brain stimulation (STN\u2010DBS) is effective for motor symptoms, its impact on facial expression remains unclear. This study aimed to objectively assess the impact of DBS on facial movement timing and amplitude using objective facial landmark\u2010based motion analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 10 PD patients with STN\u2010DBS (\u2265\u20093\u2009years) and 10 age\u2010 and sex\u2010matched controls. Standardized video recordings were obtained using a fixed camera setup. Facial movements were analyzed using objective facial landmark\u2010based motion analysis implemented via a pre\u2010trained facial landmark detection framework (Mediapipe), extracting 468 facial landmarks across approximately 1800 frames per recording. Key facial parameters, including smile completion time and region\u2010specific ranges of motion (ROM), were quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      DBS significantly increased oral commissure and frontal ROM (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) while reducing smile completion time (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). However, PD patients' smiles remained slower than those of controls (0.64\u2009\u00b1\u20090.21\u2009s vs. 0.49\u2009\u00b1\u20090.09\u2009s;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019), indicating incomplete normalization of facial expressivity. Medial eyebrow and palpebral movements showed no significant differences (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>STN\u2010DBS enhances the amplitude of some facial movements but does not fully restore temporal dynamics of facial expression. Persistent delays in smile execution suggest that aspects of facial motor control may remain impaired despite effective stimulation. Objective facial landmark\u2010based motion analysis provides a sensitive tool for detecting subtle alterations in facial motor dynamics and may support future studies investigating complementary strategies to optimize motor expressivity in PD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70497","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T10:04:24Z","timestamp":1767866664000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Objective Assessment of Facial Expressions in Parkinson's Disease During Deep Brain Stimulation\n                    <scp>ON<\/scp>\n                    and\n                    <scp>OFF<\/scp>\n                    States: A Pilot Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5583-0384","authenticated-orcid":false,"given":"Sefa","family":"Ozturk","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Istanbul Faculty of Medicine Istanbul University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duygu","family":"Dolen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Istanbul Faculty of Medicine Istanbul University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cafer Ikbal","family":"Gulsever","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Istanbul Faculty of Medicine Istanbul University  Istanbul Turkey"},{"name":"Department of Neurosurgery Hakkari State Hospital  Hakkari Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huseyin Emre","family":"Dagdeviren","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Istanbul Faculty of Medicine Istanbul University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onur","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Taksim Ac\u0131badem Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eren","family":"And\u0131c","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Istanbul Faculty of Medicine Istanbul University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senem K\u0131l\u0131c","family":"Ozturk","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Istanbul Faculty of Medicine Istanbul University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet Muhammet","family":"Kocab\u0131y\u0131k","sequence":"additional","affiliation":[{"name":"Research Centre for Computer Science and Information Security Advanced Technologies  Kocaeli Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pulat Ak\u0131n","family":"Sabanc\u0131","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Istanbul Faculty of Medicine Istanbul University  Istanbul 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