{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:37:23Z","timestamp":1792089443862,"version":"4.4.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"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. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Deep brain stimulation (DBS) is an established therapy for advanced Parkinson\u2019s disease (PD). However, its impact on neuropsychological outcomes remains controversial and lacks systematic integration. This study aims to systematically evaluate the effects of DBS on cognitive and neuropsychiatric symptoms in PD patients through a meta-analysis of randomized controlled trials (RCTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search was conducted in databases including PubMed, Embase, the Cochrane Library, and Web of Science for RCTs comparing DBS with best medical treatment (BMT). Cognitive outcome measures included Verbal Fluency test, the Stroop Color and Word Test, the Wisconsin Card Sorting Test (WCST), and the Mattis Dementia Rating Scale (MDRS). Neuropsychiatric outcome measures encompassed Part I of the Unified Parkinson\u2019s Disease Rating Scale (UPDRS-I), the Beck Depression Inventory-II (BDI-II), the Montgomery-Asberg Depression Rating Scale (MADRS), as well as the Brief Anxiety Scale (BAS) and Beck Anxiety Inventory (BAI). Risk of bias was assessed using the Cochrane RoB 2 tool, and effect sizes were pooled using RevMan 5.4 software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 10 randomized controlled trials involving 1,274 patients were included. Meta-analysis results indicated that, compared to BMT, patients undergoing DBS showed a more significant decline in performance on Verbal Fluency test and the Stroop Color-Word Interference Test. No statistically significant differences were observed between the two groups regarding overall cognitive function, cognitive flexibility, depressive symptoms, anxiety symptoms, or overall neuropsychiatric symptoms. Sensitivity analysis suggested that the effect of DBS on anxiety symptoms may vary across studies, indicating a potential beneficial role of DBS in this domain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DBS treatment did not lead to widespread cognitive or neuropsychiatric decline in patients with PD based on group-level analyses. However, within the assessed cognitive domains, mild, specific negative effects were observed on higher-order executive functions. Clinical decision-making should incorporate individualized neuropsychological assessment and monitoring to balance the benefits of motor symptom improvement with potential cognitive risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/recorddashboard<\/jats:ext-link>\n                      , this meta-analysis has been registered on the PROSPERO platform (Registration number: CRD420251273115).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1865587","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T04:33:36Z","timestamp":1781757216000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Neuropsychological outcomes comparing deep brain stimulation and best medical treatment for Parkinson\u2019s disease: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Jing","family":"Ning","sequence":"first","affiliation":[{"name":"College of Clinical Medicine, Jiangxi University of Chinese Medicine","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiujuan","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Anqiu City People's Hospital","place":["Weifang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianyu","family":"You","sequence":"additional","affiliation":[{"name":"School of Acupuncture-Moxibustion and Tuina, Jiangxi University of Chinese Medicine","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingyu","family":"Zhou","sequence":"additional","affiliation":[{"name":"College of Clinical Medicine, Jiangxi University of Chinese Medicine","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengfei","family":"An","sequence":"additional","affiliation":[{"name":"School of Acupuncture-Moxibustion and Tuina, Jiangxi University of Chinese Medicine","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhigang","family":"Zhou","sequence":"additional","affiliation":[{"name":"School of Acupuncture-Moxibustion and Tuina, Jiangxi University of Chinese Medicine","place":["Nanchang, China"]},{"name":"Acupuncture and Brain Science Research Center, Jiangxi University of Chinese Medicine","place":["Nanchang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1002\/mds.27902","article-title":"Prevalence and clinical aspects of mild cognitive impairment in Parkinson's disease: a meta-analysis","volume":"35","author":"Baiano","year":"2020","journal-title":"Mov. Disord."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1002\/ana.21795","article-title":"Stimulation of the subthalamic nucleus and impulsivity: release your horses","volume":"66","author":"Ballanger","year":"2009","journal-title":"Ann. Neurol."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1007\/s11065-022-09540-9","article-title":"Deep brain stimulation in Parkinson disease: a Meta-analysis of the long-term neuropsychological outcomes","volume":"33","author":"Bucur","year":"2023","journal-title":"Neuropsychol. Rev."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1007\/s11065-020-09467-z","article-title":"Deep brain stimulation of the subthalamic nucleus in Parkinson's disease: a Meta-analysis of mood effects","volume":"31","author":"Cartmill","year":"2021","journal-title":"Neuropsychol. Rev."},{"key":"ref5","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":"ref6","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1017\/S1092852917000062","article-title":"Neuropsychological performance changes following subthalamic versus pallidal deep brain stimulation in Parkinson's disease: a systematic review and metaanalysis","volume":"23","author":"Elgebaly","year":"2018","journal-title":"CNS Spectr."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2077","DOI":"10.1056\/NEJMoa0907083","article-title":"Pallidal versus subthalamic deep-brain stimulation for Parkinson's disease","volume":"362","author":"Follett","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1126\/science.1146157","article-title":"Hold your horses: impulsivity, deep brain stimulation, and medication in parkinsonism","volume":"318","author":"Frank","year":"2007","journal-title":"Science"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/S1474-4422(18)30499-X","article-title":"Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the global burden of disease study 2016","volume":"18","year":"2019","journal-title":"Lancet Neurol."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"66","DOI":"10.22365\/jpsych.2019.301.66","article-title":"Depression and financial capacity assessment in Parkinson's disease with dementia: overlooking an important factor?","volume":"30","author":"Giannouli","year":"2019","journal-title":"Psychiatriki"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"785","DOI":"10.3390\/brainsci11060785","article-title":"Is depression or apathy playing a key role in predicting financial capacity in Parkinson's disease with dementia and frontotemporal dementia?","volume":"11","author":"Giannouli","year":"2021","journal-title":"Brain Sci."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1136\/bmj.39489.470347.AD","article-title":"GRADE: an emerging consensus on rating quality of evidence and strength of recommendations","volume":"336","author":"Guyatt","year":"2008","journal-title":"BMJ"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/j.neurom.2022.10.051","article-title":"Eleven-year outcomes of deep brain stimulation in early-stage Parkinson disease","volume":"26","author":"Hacker","year":"","journal-title":"Neuromodulation"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"105479","DOI":"10.1016\/j.parkreldis.2023.105479","article-title":"2Long-term neuropsychological outcomes of deep brain stimulation in early-stage Parkinson's disease","volume":"113","author":"Hacker","year":"","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1002\/mds.30218","article-title":"Theta-gamma subthalamic stimulation for verbal fluency in Parkinson's disease: a randomized, crossover trial","volume":"40","author":"Imbalzano","year":"2025","journal-title":"Mov. Disord."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1038\/nrn4038","article-title":"A fronto-striato-subthalamic-pallidal network for goal-directed and habitual inhibition","volume":"16","author":"Jahanshahi","year":"2015","journal-title":"Nat. Rev. Neurosci."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1038\/s41531-022-00443-3","article-title":"Subthalamic beta bursts correlate with dopamine-dependent motor symptoms in 106 Parkinson's patients","volume":"9","author":"Lofredi","year":"2023","journal-title":"NPJ Parkinsons Dis."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"357","DOI":"10.3171\/2019.12.JNS192654","article-title":"22 short- and long-term cognitive effects of deep brain stimulation in the caudal zona incerta versus best medical treatment in patients with Parkinson's disease","volume":"134","author":"Philipson","year":"2021","journal-title":"J. Neurosurg."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1136\/jnnp-2014-308119","article-title":"Neuropsychological changes following deep brain stimulation surgery for Parkinson's disease: comparisons of treatment at pallidal and subthalamic targets versus best medical therapy","volume":"86","author":"Rothlind","year":"2015","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1016\/j.parkreldis.2014.03.020","article-title":"Systematic review of factors associated with depression and anxiety disorders among older adults with Parkinson's disease","volume":"20","author":"Sagna","year":"2014","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/S1474-4422(14)70287-X","article-title":"Prediagnostic presentations of Parkinson's disease in primary care: a case-control study","volume":"14","author":"Schrag","year":"2015","journal-title":"Lancet Neurol."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1995","DOI":"10.1093\/brain\/awf199","article-title":"Subthalamic nucleus stimulation affects striato-anterior cingulate cortex circuit in a response conflict task: a PET study","volume":"125","author":"Schroeder","year":"2002","journal-title":"Brain"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1212\/01.wnl.0000250253.03919.fb","article-title":"Neurosurgery at an earlier stage of Parkinson disease: a randomized, controlled trial","volume":"68","author":"Schuepbach","year":"2007","journal-title":"Neurology"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1056\/NEJMoa1205158","article-title":"Neurostimulation for Parkinson's disease with early motor complications","volume":"368","author":"Schuepbach","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1002\/mds.29772","article-title":"Bidirectional interplay between deep brain stimulation and cognition in Parkinson's disease: a systematic review","volume":"39","author":"Sisodia","year":"2024","journal-title":"Mov. Disord."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"151","DOI":"10.3233\/JPD-140448","article-title":"Neuropsychological effects of deep brain stimulation in subjects with early stage Parkinson's disease in a randomized clinical trial","volume":"5","author":"Tramontana","year":"2015","journal-title":"J. Parkinsons Dis."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1080\/14737175.2024.2360121","article-title":"Developments in the prediction of cognitive changes following deep brain stimulation in persons with Parkinson's disease","volume":"24","author":"Troster","year":"2024","journal-title":"Expert. Rev. Neurother."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1016\/S1474-4422(10)70093-4","article-title":"Deep brain stimulation plus best medical therapy versus best medical therapy alone for advanced Parkinson's disease (PD SURG trial): a randomised, open-label trial","volume":"9","author":"Williams","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1016\/S1474-4422(08)70114-5","article-title":"Neuropsychological and psychiatric changes after deep brain stimulation for Parkinson's disease: a randomised, multicentre study","volume":"7","author":"Witt","year":"2008","journal-title":"Lancet Neurol."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"106450","DOI":"10.1016\/j.clineuro.2020.106450","article-title":"STN versus GPi deep brain stimulation for dyskinesia improvement in advanced Parkinson's disease: a meta-analysis of randomized controlled trials","volume":"201","author":"Zhang","year":"2021","journal-title":"Clin. Neurol. Neurosurg."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1865587\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T04:33:42Z","timestamp":1781757222000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2026.1865587\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,18]]},"references-count":31,"alternative-id":["10.3389\/fpsyg.2026.1865587"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2026.1865587","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,18]]},"article-number":"1865587"}}