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Pract."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established treatment for Parkinson\u2019s disease (PD). Beyond basic omnidirectional, monopolar stimulation, advanced stimulation settings (AS), such as directional or vertical current steering, variation of pulse width and frequency, bipolar and interleaving stimulation are increasingly available. Our aim was to summarize current evidence on AS in STN-DBS in PD and systemically report their application and potential benefits in clinical routine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective single-center observational study, we analyzed stimulation settings of 145 patients with bilateral STN-DBS 3, 6, and 12\u00a0months postoperatively. Secondary outcomes included preoperative levodopa response, lead positions, and postoperative reduction of levodopa-equivalent daily dose (LEDD) in patients staying with basic stimulation settings (BS) compared to those initially with AS at 3-months follow-up and those with a change from BS to AS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>AS were applied in 40.7%, 55.9%, and 73.8% of patients at 3, 6, and 12\u00a0months respectively. LEDD reduction after three months was higher in patients remaining with BS or initially AS than in patients with a switch to AS after three months, while there was no difference at 12\u00a0months. Median distance of leads to the center of gravity of the motor-STN was slightly larger when AS were applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AS are frequently employed in clinical routine at a specialized DBS center. They may compensate for deviant lead placement in terms of stimulation efficacy measured by postoperative LEDD reduction. Prospective studies are warranted, focusing on specific AS indications in chronic DBS to optimize individual patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s42466-026-00477-5","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:13:03Z","timestamp":1783008783000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Stimulation settings in subthalamic nucleus deep brain stimulation for parkinson\u2019s disease \u2013 a retrospective single-center observational study"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4465-1986","authenticated-orcid":false,"given":"Charlotte","family":"Schedlich-Teufer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor A.","family":"Brandt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"van der Linden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Jergas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Baldermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasilija","family":"Stopic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gereon R.","family":"Fink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veerle","family":"Visser-Vandewalle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till A.","family":"Dembek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Barbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Niklas","family":"Petry-Schmelzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"477_CR1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00410","volume":"10","author":"T Koeglsperger","year":"2019","unstructured":"Koeglsperger, T., Palleis, C., Hell, F., Mehrkens, J. 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During the incorporation of the proof corrections, some of the rows in tables 1 and 3 seem to have been inadvertently shifted. Additionally, table 3 and figure 3 are now displayed across the entire width of the page for better readability.","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 August 2026","order":8,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":9,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":10,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1186\/s42466-026-00517-0","URL":"https:\/\/doi.org\/10.1186\/s42466-026-00517-0","order":11,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Due to the retrospective character of the study, formal ethical approval was waived by the local ethics committee (University of Cologne, Study No. 25\u20131167). Informed patient consent was not necessary for this work.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"CST received personal funding from Medtronic, outside of the submitted work. GAB received personal fees from Boston Scientific and Medtronic, outside of the submitted work. CvdL was supported by the Cologne Clinician Scientist Program (CCSP) \/ Faculty of Medicine \/ University of Cologne and received personal funding from Medtronic, outside of the submitted work. HJ received personal fees from Boston Scientific, outside of the submitted work. JCB is funded by the Else-Kr\u00f6ner-Fresenius-Stiftung (2022_EKES.23). VS was supported by the Else Kr\u00f6ner-Fresenius-Stiftung and the Advanced Cologne Clinician Scientist Program of the Medical Faculty of the University of Cologne. GRF serves as an editorial board member of NeuroImage: Clinical, Zeitschrift f\u00fcr Neuropsychologie, Zeitschrift f\u00fcr Kinder- und Jugendpsychiatrie und Psychotherapie, and Info Neurologie & Psychiatrie; receives royalties for the books Funktionelle MRT in Psychiatrie und Neurologie, Neurologische Differentialdiagnose, SOP Neurologie, and Therapiehandbuch Neurologie; receives royalties for the neuropsychological tests KAS, NP-KiSS, and K\u00f6pSS; receives honoraria for speaking engagements by the Deutsche Gesellschaft f\u00fcr Neurologie (DGN) and Forum f\u00fcr medizinische Fortbildung FomF GmbH. VVV received financial support for contributions to congresses and advisory boards from Insightec, Medtronic, and Boston Scientific, and research funding from the two latter. TAD received speaker\u2019s honoraria and travel grants from Boston Scientific. MTB received speaker\u2019s honoraria from Medtronic, Boston Scientific, Abbott (formerly St. Jude), FomF, derCampus, GE Medical, UCB, Bial, Apothekerverband K\u00f6ln e.V., BDN, Ever Pharma, Esteve as well as advisory honoraria for the IQWIG, Medtronic, Esteve, Boston Scientific and Abbvie. Research funding was provided by the Felgenhauer-Stiftung, Forschungspool Klinische Studien, and K\u00f6ln Fortune (University of Cologne), Horizon 2020 (Gondola), Medtronic (ODIS, OPEL, BeAble), and Boston Scientific. JNPS has nothing to report.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"53"}}