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We have previously described three patients with severe apathy that could be fully treated after switching stimulation from a ventral electrode contact point to a more dorsal contact point.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>To determine whether more dorsal stimulation of the STN decreases apathy compared to standard care in a multicenter randomized controlled trial with a crossover design.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We will include 26 patients with a Starkstein Apathy Scale (SAS) score of 14 or more after subthalamic nucleus (STN) deep brain stimulation (DBS) for refractory Parkinson\u2019s disease. This is a multicenter trial conducted in two teaching hospitals and one university medical center in the Netherlands after at least 3\u00a0months of STN DBS. Our intervention will consist of 1\u00a0month of unilateral dorsal STN stimulation compared to treatment as usual. The primary outcome is a change in SAS score following 1\u00a0month of DBS on the original contact compared to the SAS score following 1\u00a0month of DBS on the more dorsal contact. Secondary outcomes are symptom changes on the Movement Disorders Society-Unified Parkinson\u2019s Disease Rating Scale motor part III, Montgomery-\u00c5sberg Depression Rating Scale, 39-item Parkinson\u2019s disease questionnaire, Parkinson\u2019s disease impulsive-compulsive disorders questionnaire, changes in levodopa-equivalent daily dosage, apathy rated by the caregiver, and burden and quality of life of the caregiver.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>ClinicalTrials.gov NL8279. Registered on January 10, 2020.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13063-024-07938-9","type":"journal-article","created":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T03:02:02Z","timestamp":1706929322000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A multicenter double-blind randomized crossover study comparing the impact of dorsal subthalamic nucleus deep brain stimulation versus standard care on apathy in Parkinson\u2019s disease: a study protocol"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9198-4476","authenticated-orcid":false,"given":"T. J. C.","family":"Zoon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"van Rooijen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. 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Protocol version 1.3 was submitted to the METC on April 13, 2020. Written informed consent to participate will be obtained from all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate {24}"}},{"value":"Not applicable \u2014 no identifying images or other personal or clinical details of participants are presented here or will be presented in reports of the trial results. The participant information materials and informed consent form are available from the corresponding authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication {32}"}},{"value":"Dr. van Munckhof reports a grant from the Dutch Brain Foundation during the conduct of the study. Prof. Dr. Schuurman reported personal fees from Medtronic and Boston Scientific during the conduct of the study. No other disclosures were reported. Prof. Dr. Denys received grants from ZonMW and Boston Scientific for a trial on deep brain stimulation for depression. Prof. Dr. de Bie reports grants from Hersenstichting Charitable Organization during the conduct of the study and grants from the Netherlands Organization for Health Research and Development, Stichting Parkinson Nederland, GE Healthcare, Medtronic, Lysosomal Therapeutics, and Neuroderm, all paid to institutions, outside the submitted work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests {28}"}}],"article-number":"104"}}