{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T12:00:23Z","timestamp":1767873623509,"version":"3.49.0"},"reference-count":84,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Deep brain stimulation (DBS) is increasingly understood as a precision-oriented neuromodulation therapy capable of influencing distributed basal ganglia\u2013thalamo\u2013cortical and cerebellothalamic networks. Although its symptomatic benefits in Parkinson\u2019s disease, essential tremor, and dystonia are well established, the extent to which DBS supports motor learning, adaptive plasticity, and participation in rehabilitation remains insufficiently defined. Traditional interpretations of DBS as a focal or lesion-like intervention are being challenged by electrophysiological and imaging evidence demonstrating multiscale modulation of circuit dynamics. Objectives and methods: DBS may enhance rehabilitation outcomes by stabilizing pathological oscillations and reducing moment-to-moment variability in motor performance, thereby enabling more consistent task execution and more effective physiotherapy, occupational therapy, and speech\u2013language interventions. However, direct comparative evidence demonstrating additive or synergistic effects of DBS combined with rehabilitation remains limited. As a result, this potential is not fully realized in clinical practice due to interindividual variability, limited insight into how individual circuit architecture shapes therapeutic response, and the limited specificity of current connectomic biomarkers for predicting functional gains. Results: Technological advances such as tractography-guided targeting, directional leads, sensing-enabled devices, and adaptive stimulation are expanding opportunities to align neuromodulation with individualized circuit dysfunction. Despite these developments, major conceptual and empirical gaps persist. Few controlled studies directly compare outcomes with versus without structured rehabilitation following DBS. Heterogeneity in therapeutic response and rehabilitation access further complicates the interpretation of outcomes. Clarifying these relationships is essential for developing precision-informed frameworks that integrate DBS with rehabilitative strategies, recognizing that current connectomic and physiological biomarkers remain incompletely validated for predicting functional outcomes. Conclusions: This review synthesizes mechanistic, imaging, and technological evidence to outline a network-informed perspective of DBS as a potential facilitator of rehabilitation-driven functional improvement and identifies priorities for future research aimed at optimizing durable functional restoration.<\/jats:p>","DOI":"10.3390\/jcm15020492","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T09:01:29Z","timestamp":1767862889000},"page":"492","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Deep Brain Stimulation as a Rehabilitation Amplifier: A Precision-Oriented, Network-Guided Framework for Functional Restoration in Movement Disorders"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7313-040X","authenticated-orcid":false,"given":"Olga","family":"Mateo-Sierra","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Gregorio Mara\u00f1\u00f3n University Hospital, C\/Dr Esquerdo 46, 28007 Madrid, Spain"},{"name":"Gregorio Mara\u00f1\u00f3n Research Institute, Gregorio Mara\u00f1\u00f3n University General Hospital, C\/Dr Esquerdo 46, 28007 Madrid, Spain"},{"name":"Department of Surgery, Medicine School, Complutense University of Madrid, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0486-3308","authenticated-orcid":false,"given":"Beatriz","family":"De la Casa-Fages","sequence":"additional","affiliation":[{"name":"Gregorio Mara\u00f1\u00f3n Research Institute, Gregorio Mara\u00f1\u00f3n University General Hospital, C\/Dr Esquerdo 46, 28007 Madrid, Spain"},{"name":"Movement Disorders Unit, Department of Neurology, Gregorio Mara\u00f1\u00f3n University Hospital, C\/Dr Esquerdo 46, 28007 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Mart\u00edn-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gregorio Mara\u00f1\u00f3n University Hospital, C\/Dr Esquerdo 46, 28007 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Barreiro-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Gregorio Mara\u00f1\u00f3n University Hospital, C\/Dr Esquerdo 46, 28007 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Grandas","sequence":"additional","affiliation":[{"name":"Gregorio Mara\u00f1\u00f3n Research Institute, Gregorio Mara\u00f1\u00f3n University General Hospital, C\/Dr Esquerdo 46, 28007 Madrid, Spain"},{"name":"Movement Disorders Unit, Department of Neurology, Gregorio Mara\u00f1\u00f3n University Hospital, C\/Dr Esquerdo 46, 28007 Madrid, Spain"},{"name":"Department of Medicine, Medicine School, Complutense University of Madrid, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1002\/mds.22838","article-title":"How common is the most common adult movement disorder? 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