Subthalamic DBS Engages Right-lateralized Frontal Control to Improve Gait Adaptation in Parkinson's Disease.
Active DBS was associated with better gait adaptation and a shift toward right-frontal network activity in this small mechanistic study. It does not yet define an individual programming rule or show durable everyday benefit.
Hanafi I, Pozzi NG, Habib R, Falciglia S, Del Vecchio Del Vecchio J, Remore LG, Marotta G, Buck A, Pezzoli G, Volkmann J, Isaias IU, Palmisano C.
Brain stimulation · Publication date: 2026-09-18
Added to site: 2026-09-19
DOI: 10.1016/j.brs.2026.103207
Online-ahead-of-print publication date verified in PubMed.
- Modalities
- EEG, DBS, PET
- Clinical focus
- Parkinson's disease, Gait adaptation, Network modulation
- Population
- People with Parkinson's disease treated with STN-DBS and age-matched healthy comparators
- Sample
- 12 people with Parkinson's disease; 8 age-matched healthy participants for comparative kinematics
- Intervention / method
- Immersive virtual-reality overground obstacle adaptation under active and paused STN-DBS, EEG during gait, and three [18F]FDG PET scans after rest and after gait adaptation in each stimulation condition
- Comparator
- Active versus paused STN-DBS within participants; healthy participants completed the gait task for kinematic comparison
Clinician summary
Active STN-DBS increased thalamic and superior-frontal metabolism and reduced cerebellar uptake. Right-lateralized superior-frontal activity tracked gait adaptation, while frontal theta asymmetry offered complementary EEG evidence.
How to interpret the findings
Only 12 DBS-treated participants were studied. The accessible abstract does not establish randomization, order control, blinding, adverse-event reporting or durability. Metabolic and EEG associations do not validate a prospective image-guided programming algorithm.
Equipment and disclosures
Participants had subthalamic deep-brain stimulation, and the study used EEG, immersive virtual reality and [18F]FDG PET. Device, electrode and EEG-system models were not specified in the accessible abstract.
The indexed conflict statement reports financial support for Ioannis U. Isaias from the German Research Foundation and NYU Grossman School of Medicine, and for Ibrahem Hanafi from the German Academic Exchange Service. Other authors declared no known competing interests.
Related evidence
Compare findings from the same clinical area, including mixed results.
- Anisotropic conductivity modeling for tDCS in Parkinson’s disease using multidimensional diffusion MRI · Positive with limitations
- Noninvasive brain stimulation for motor function and quality of life in Parkinson’s disease: a systematic review and network meta-analysis · Positive with limitations
- Explorative investigation on effects of multi-day neurofeedback with implanted electrodes in patients with Parkinson's disease. · Mixed
- High-frequency rTMS over supplementary motor or primary motor cortex on reach-to-grasp in Parkinson's disease: A randomised controlled trial. · Positive with limitations
Summary prepared with AI assistance. Source verification does not imply an independent replication or a clinician's endorsement. Read our review method.