Evidence map›Paper›PMID 42860886›Full record

ArticleMovement disorders clinical practice2026

Disease Duration Differentiates Freezing of Gait Response to Subthalamic and Nigral Stimulation for Parkinson's Disease in an Exploratory Multicenter Controlled Trial.

Daniel Weiss, Idil Cebi, Marion Schütt, Imma Fischer, Lukas Pavelka, Pierre Kolber, Monika Pötter-Nerger, Wolfgang Hamel, Andrea A Kühn, Christian J Hartmann and 12 more

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Article in Movement disorders clinical practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Daniel WeissCentre for Neurology, Department for Neurodegenerative Diseases, and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.ORCID https://orcid.org/0000-0003-0447-7132
Idil CebiCentre for Neurology, Department for Neurodegenerative Diseases, and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
Marion SchüttInstitute for Clinical Epidemiology and Applied Biometry, University of Tübingen, Hamburg, Germany.ORCID https://orcid.org/0009-0007-7374-5053
Imma FischerInstitute for Clinical Epidemiology and Applied Biometry, University of Tübingen, Hamburg, Germany.
Lukas PavelkaParkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg; and Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg; and Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg.ORCID https://orcid.org/0000-0002-7721-3317
Pierre KolberParkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg; and Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg; and Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg.
Monika Pötter-NergerDepartment of Neurology, and Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.ORCID https://orcid.org/0000-0001-7680-2147
Wolfgang HamelDepartment of Neurology, and Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Andrea A KühnDepartment of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.ORCID https://orcid.org/0000-0002-4134-9060
Christian J HartmannInstitute of Clinical Neuroscience and Medical Psychology, and Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
Kai BötzelDepartment of Neurology, University Hospital of the LMU Munich, Munich, Germany.
Thomas KöglspergerDepartment of Neurology, University Hospital of the LMU Munich, Munich, Germany.ORCID https://orcid.org/0000-0001-6101-0323
Michael T BarbeDepartment of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Jülich, Germany.ORCID https://orcid.org/0000-0003-1149-8054
Zacharias KohlDepartment of Neurology, University of Regensburg, Regensburg, Germany.ORCID https://orcid.org/0000-0002-4147-8866
Steffen PaschenDepartment of Neurology, UKSH, Campus Kiel Christian-Albrechts-University, Kiel, Germany.ORCID https://orcid.org/0000-0002-9306-8332
Markus A HobertDepartment of Neurology, UKSH, Campus Kiel Christian-Albrechts-University, Kiel, Germany.ORCID https://orcid.org/0000-0002-7558-8107
Sergiu GroppaImaging and Neurostimulation, Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Tobias WarneckeDepartment of Neurology, University of Münster, Münster, Germany.
Inga ClausDepartment of Neurology, University of Münster, Münster, Germany.
Rejko KrügerParkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg; and Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg; and Translational Neuroscience, Luxembourg Centre for Systems Biomedicine (LCSB), University of Luxembourg, Esch-sur-Alzette, Luxembourg.ORCID https://orcid.org/0000-0003-4258-6241
Alireza GharabaghiInstitute for Neuromodulation and Neurotechnology, Tübingen, Germany.ORCID https://orcid.org/0000-0002-9782-5281
Multicenter STN+SNr Study Group

Funding

Medtronic
6 · The paper itself

Abstract

backgroundFreezing of gait (FoG) belongs to most pressing unmet symptoms in the treatment of Parkinson's disease.

objectivesTo explore whether combined subthalamic and nigral (STN + SNr) deep brain stimulation improves FoG compared with optimized STN stimulation alone; to identify clinical variables associated with therapeutic response.

methodsIn this exploratory multicenter randomized controlled double-blind trial, we recruited patients from our existing cohorts and randomized them 1:1 to STN or STN + SNr. After baseline, patients were followed with close interim visits (visits 1-5) for 90 days (visit 6). The Freezing of Gait Assessment Course (FoG-AC) was the primary endpoint and was evaluated at P < 0.2 with exploratory intent. Secondary endpoints assessed responder rates, treatment dynamics, predictors of response, and patient preferences.

resultsAt V6, STN (n = 23) and STN + SNr (n = 22) FoG-AC outcomes did not differ significantly. We identified responders with clinically meaningful FoG improvement in both the STN (n = 7) and STN + SNr (n = 8) groups. In STN + SNr responders, mean disease duration was ~12 years, which was ~4.5 years shorter than in non-responders, but there were no differences in motor and cognitive functions. Treatment dynamics suggested that FoG responders improved slowly and gradually. The STN + SNr responder group showed numerically stronger FoG improvement compared with STN responders. Additionally, 15 STN compared to 10 STN + SNr patients wished to change treatment after the RCT phase and before unblinding. Both STN and STN + SNr treatment was safe.

conclusionsFuture trials evaluating adjunctive STN + SNr stimulation should stratify patients by disease duration to optimize outcomes.

Indexed as

deep brain stimulationfreezinggaitParkinson's diseasesubstantia nigrasubthalamic nucleus

Identifiers

PMID42860886
PMCPMC13655711

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.