{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T04:19:06Z","timestamp":1784953146911,"version":"3.55.0"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T00:00:00Z","timestamp":1768521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to examine the very long-term effects of globus pallidus interna (GPi) or subthalamic nucleus (STN) deep brain stimulation (DBS) on Parkinson\u2019s disease (PD) in a subset of patients enrolled in the CSP468 VA\/NINDS prospective randomized trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The primary outcome was the change in off-medication\/on-stimulation Unified Parkinson\u2019s Disease Rating Scale III score (UPDRS III) from baseline over time between the two targets at 2, 7, and 10\u202fyears. Many secondary outcomes were also explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 156 patients were enrolled in this substudy, and data were available for 68 GPi\/49 STN participants at 7\u202fyears and 49 GPi\/28 STN participants at 10\u202fyears. There was no overall difference in the time trend between the two targets (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.09). UPDRS III improvements from baseline in the GPi cohort at 2, 7, and 10 years were 39.9% (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), 16.4%, (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and 22.3%, (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.10), respectively, and in the STN cohort at 2, 7, and 10 years it was 34.9% (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), 16.9%, (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and 32.8%, (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), respectively. Tremor subscores showed the greatest reduction, followed by rigidity subscores. Initial improvements in bradykinesia and axial subscores were attenuated, and UPDRS I, II, and III on-medication\/on-stimulation scores significantly declined. UPDRS IV scores and motor diaries showed significant long-term improvement, and medication reductions were seen regardless of the target. At 7 and 10\u202fyears, the PDQ-39 total score no longer showed improvement, and more severe cognitive impairment was seen in both targets.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DBS therapy has a significant beneficial effect on overall motor function, dyskinesia, and motor fluctuations over 10\u202fyears (regardless of target), though non-motor symptoms progressed. Bradykinesia, axial, and quality-of-life improvement were maintained at 2\u202fyears and then declined over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>ClinicalTrials.gov<\/jats:ext-link>\n                      , identifier NCT01022073, NCT00056563, NCT01076452.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1728999","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:54:11Z","timestamp":1768571651000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["10-year clinical outcomes of subthalamic nucleus versus pallidal deep brain stimulation for Parkinson\u2019s disease: VA\/NINDS CSP #468F"],"prefix":"10.3389","volume":"16","author":[{"given":"Jill L.","family":"Ostrem","sequence":"first","affiliation":[{"name":"Department of Neurology, University of California, San Francisco","place":["San Francisco, CA, United States"]},{"name":"San Francisco VA Medical Center","place":["San Francisco, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Luo","sequence":"additional","affiliation":[{"name":"Edward Hines Jr, VA Hospital","place":["Hines, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances M.","family":"Weaver","sequence":"additional","affiliation":[{"name":"Edward Hines Jr, VA Hospital","place":["Hines, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Follett","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Nebraska Medical Center","place":["Omaha, NE, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Rothlind","sequence":"additional","affiliation":[{"name":"San Francisco VA Medical Center","place":["San Francisco, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas B.","family":"Galifianakis","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of California, San Francisco","place":["San Francisco, CA, United States"]},{"name":"San Francisco VA Medical Center","place":["San Francisco, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene C.","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Neurology, Houston Methodist Neurological Institute","place":["Houston, TX, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Bronstein","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of California, Los Angeles","place":["Los Angeles, CA, United States"]},{"name":"West Los Angeles VA Medical Center","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Duda","sequence":"additional","affiliation":[{"name":"Department of Neurology, Philadelphia VA Medical Center","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Holloway","sequence":"additional","affiliation":[{"name":"McGuire VA Medical Center","place":["Richmond, VA, United States"]},{"name":"Department of Neurosurgery, Virginia Commonwealth University","place":["Richmond, VA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliya","family":"Sarwar","sequence":"additional","affiliation":[{"name":"Department of Neurology, Baylor College of Medicine","place":["Houston, TX, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Brodsky","sequence":"additional","affiliation":[{"name":"Department of Neurology, Oregon Health Science University","place":["Portland, OR, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Chung","sequence":"additional","affiliation":[{"name":"Portland VA Medical Center","place":["Portland, OR, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Spindler","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Pennsylvania","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenic","family":"Reda","sequence":"additional","affiliation":[{"name":"Edward Hines Jr, VA Hospital","place":["Hines, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Snodgrass","sequence":"additional","affiliation":[{"name":"VA Cooperative Studies Program Clinical Research Pharmacy Coordinating Center","place":["Albuquerque, NM, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Moy","sequence":"additional","affiliation":[{"name":"The National Institutes of Neurological Disorders and Stroke","place":["Bethesda, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Huang","sequence":"additional","affiliation":[{"name":"The Department of Veterans Affairs Cooperative Studies Program Central Office","place":["Washington, DC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongliang","family":"Wei","sequence":"additional","affiliation":[{"name":"Edward Hines Jr, VA Hospital","place":["Hines, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"William J.","family":"Marks","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stanford University School of Medicine","place":["Stanford, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the CSP 468F Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1056\/NEJMoa060281","article-title":"A randomized trial of deep-brain stimulation for Parkinson's disease","volume":"355","author":"Deuschl","year":"2006","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1001\/jama.2008.929","article-title":"Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson 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A controlled longitudinal study","volume":"7","author":"Mahlknecht","year":"2020","journal-title":"Mov Disord Clin Pract"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1581","DOI":"10.1002\/mds.29052","article-title":"How does deep brain stimulation change the course of Parkinson's disease?","volume":"37","author":"Mahlknecht","year":"2022","journal-title":"Mov Disord"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1038\/s41587-019-0244-6","article-title":"Emerging technologies for improved deep brain stimulation","volume":"37","author":"Cagnan","year":"2019","journal-title":"Nat Biotechnol"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1728999\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T07:35:42Z","timestamp":1771918542000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1728999\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,16]]},"references-count":49,"alternative-id":["10.3389\/fneur.2025.1728999"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1728999","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,16]]},"article-number":"1728999"}}