{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:16:02Z","timestamp":1788156962048,"version":"build-2803163510"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"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>Introduction<\/jats:title>\n                    <jats:p>Deep brain stimulation (DBS) outcomes in Parkinson\u2019s disease (PD) are strongly influenced by postoperative programming, yet real-world workflows and adoption of newer technologies, including directional stimulation, sensing-enabled systems, and adaptive DBS, vary across clinical settings. This study aimed to describe contemporary real-world DBS programming practices for PD among clinicians across India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an anonymous, cross-sectional, web-based survey of Indian clinicians actively programming DBS for PD with \u22651\u202fyear of experience. The survey assessed initial programming workflows, symptom-specific optimization strategies, medication adjustment practices, use of sensing-enabled technologies, approaches to suboptimal response, respondent-level workflow patterns, and perceptions of adaptive DBS. Results were analyzed descriptively using item-specific denominators; multi-select responses were summarized as option-level proportions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty of 54 approached clinicians completed the survey. Respondents represented 37 DBS centres across 18 Indian cities. The subthalamic nucleus was the most commonly selected target (42\/50, 84.0%). Stimulation was most often initiated within 1\u20132\u202fweeks (25\/50, 50.0%) or 3\u20134\u202fweeks (14\/50, 28.0%) after implantable pulse generator implantation. Initial programming strategies were captured as a multi-select item; the most frequently selected strategy was a combination of monopolar review and BrainSense (35\/50, 70.0%), followed by traditional monopolar review (22\/50, 44.0%). Current BrainSense use was reported by 42\/50 respondents (84.0%); among current users, initiation most often occurred at initial programming (26\/42, 61.9%). Symptom-specific optimization strategies varied by clinical problem: amplitude adjustment was most frequently selected for bradykinesia (42\/50, 84.0%) and rigidity (45\/50, 90.0%), while frequency adjustment was most frequently selected for tremor (47\/50, 94.0%) and freezing of gait (43\/50, 86.0%). For suboptimal response, imaging-based lead localization strategies were frequently selected, particularly pre\u2212\/post-operative imaging merge with lead location review (44\/50, 88.0%). Exploratory respondent-level analysis identified overlapping workflow domains, including sensing-integrated programming (26\/50, 52.0%) and technology-assisted troubleshooting (29\/50, 58.0%); 31\/50 respondents (62.0%) fell into the high workflow\/technology-integration score category. Most respondents intended to incorporate adaptive DBS into routine clinical practice (45\/50, 90.0%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This multicentre survey provides a snapshot of contemporary DBS programming practices for PD in India, highlighting practice variability, increasing adoption of technology-assisted programming, and strong interest in adaptive DBS. These findings support the need for context-specific training and future outcome-based research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1892612","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:41:51Z","timestamp":1788154911000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-world deep brain stimulation programming practices for Parkinson\u2019s disease in India: variability, technology adoption, and emerging trends from a multicentre clinician survey across India"],"prefix":"10.3389","volume":"17","author":[{"given":"Pramod Kumar","family":"Pal","sequence":"first","affiliation":[{"name":"Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS)","place":["Bangalore, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roopa","family":"Rajan","sequence":"additional","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences (AIIMS)","place":["Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syam","family":"Krishnan Nair","sequence":"additional","affiliation":[{"name":"Department of Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)","place":["Trivandrum, Kerala, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS)","place":["Bangalore, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohit","family":"Anand","sequence":"additional","affiliation":[{"name":"Department of Neurology, Artemis Hospital","place":["Gurgaon, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shankar","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rela Hospital","place":["Chennai, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish","family":"Baldia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Wockhardt Hospital","place":["Mumbai, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anirban Deep","family":"Banarjee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medanta Institute of Neurosciences","place":["Gurgaon, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupam","family":"Borgohain","sequence":"additional","affiliation":[{"name":"Department of Parkinson\u2019s and Movement Disorders Research Centre (PDMDRC), Yashoda Hospitals","place":["Hyderabad, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacky","family":"Ganguly","sequence":"additional","affiliation":[{"name":"Department of Neurology, Movement Disorder Centre, Institute of Neurosciences Kolkata","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhanunjay Rao","family":"Ginjupally","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Apollo Health City","place":["Hyderabad, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram V","family":"Holla","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS)","place":["Bangalore, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guruprasad","family":"Hosurkar","sequence":"additional","affiliation":[{"name":"Department of Neurology, Head of Parkinson\u2019s Disease and Movement Disorder Programme, Krishna Institute of Medical Sciences (KIMS) Hospitals","place":["Bangalore, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitesh","family":"Kamble","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS)","place":["Bangalore, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rukmini Mridula","family":"Kandadai","sequence":"additional","affiliation":[{"name":"Department of Parkinson\u2019s and Movement Disorders Research Centre (PDMDRC), Yashoda Hospitals","place":["Hyderabad, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshat","family":"Kayal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Kokilaben Dhirubhai Ambani Hospital","place":["Mumbai, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhijeet Kumar","family":"Kohat","sequence":"additional","affiliation":[{"name":"Department of Neurology, Dau Kalyan Singh Post Graduate Institute and Research Centre","place":["Raipur, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hrishikesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Neurology, Movement Disorder Centre, Institute of Neurosciences Kolkata","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan R","family":"Mahale","sequence":"additional","affiliation":[{"name":"Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS)","place":["Bangalore, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaibhav","family":"Matur","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Narayana Multispeciality Hospital","place":["Jaipur, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreeram","family":"Prasad","sequence":"additional","affiliation":[{"name":"Advanced Center for Movement Disorders 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India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Venkatachalam","sequence":"additional","affiliation":[{"name":"Department of Neurology, Apollo Hospitals","place":["Navi Mumbai, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Shankar","sequence":"additional","affiliation":[{"name":"Department of Neurology, Apollo Hospitals","place":["Chennai, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavadisseril Vivekanandan","family":"Vysakh","sequence":"additional","affiliation":[{"name":"Department of Neurology, Caritas Neuro Sciences","place":["Kottayam, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sireesha","family":"Yareeda","sequence":"additional","affiliation":[{"name":"Department of Neurology, Nizam\u2019s Institute of Medical Sciences (NIMS)","place":["Hyderabad, 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