Patient Selection in Deep Brain Stimulation: A Role for Transcranial Direct Current Stimulation to Enhance the Levodopa Challenge?

ABSTRACT Dopaminergic medication and deep brain stimulation (DBS) improve motor symptoms in Parkinson's disease (PD), but levodopa response alone may not predict DBS outcomes. We retrospectively analyzed 19 PD patients undergoing levodopa challenges with and without prior transcranial direct cu...

Full description

Saved in:
Bibliographic Details
Main Authors: Lukas L. Goede, Patricia Zvarova, Bahne H. Bahners, Andreas Horn
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Annals of Clinical and Translational Neurology
Subjects:
Online Access:https://doi.org/10.1002/acn3.70073
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849771132052307968
author Lukas L. Goede
Patricia Zvarova
Bahne H. Bahners
Andreas Horn
author_facet Lukas L. Goede
Patricia Zvarova
Bahne H. Bahners
Andreas Horn
author_sort Lukas L. Goede
collection DOAJ
description ABSTRACT Dopaminergic medication and deep brain stimulation (DBS) improve motor symptoms in Parkinson's disease (PD), but levodopa response alone may not predict DBS outcomes. We retrospectively analyzed 19 PD patients undergoing levodopa challenges with and without prior transcranial direct current stimulation targeting a defined PD response network. Levodopa improved motor performance more after tDCS than sham (41.72% vs. 31.52%; p < 0.001). In ten patients who later received DBS, the combined levodopa‐tDCS response accounted for DBS outcomes (p = 0.02). These findings suggest that targeted tDCS enhances levodopa effects and may be of potential use to optimize DBS candidate selection.
format Article
id doaj-art-d2acd7da2c2346808b706233f3a288ce
institution DOAJ
issn 2328-9503
language English
publishDate 2025-08-01
publisher Wiley
record_format Article
series Annals of Clinical and Translational Neurology
spelling doaj-art-d2acd7da2c2346808b706233f3a288ce2025-08-20T03:02:44ZengWileyAnnals of Clinical and Translational Neurology2328-95032025-08-011281698170110.1002/acn3.70073Patient Selection in Deep Brain Stimulation: A Role for Transcranial Direct Current Stimulation to Enhance the Levodopa Challenge?Lukas L. Goede0Patricia Zvarova1Bahne H. Bahners2Andreas Horn3Center for Brain Circuit Therapeutics, Departments of Neurology, Psychiatry, and Radiology Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USACenter for Brain Circuit Therapeutics, Departments of Neurology, Psychiatry, and Radiology Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USACenter for Brain Circuit Therapeutics, Departments of Neurology, Psychiatry, and Radiology Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USACenter for Brain Circuit Therapeutics, Departments of Neurology, Psychiatry, and Radiology Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USAABSTRACT Dopaminergic medication and deep brain stimulation (DBS) improve motor symptoms in Parkinson's disease (PD), but levodopa response alone may not predict DBS outcomes. We retrospectively analyzed 19 PD patients undergoing levodopa challenges with and without prior transcranial direct current stimulation targeting a defined PD response network. Levodopa improved motor performance more after tDCS than sham (41.72% vs. 31.52%; p < 0.001). In ten patients who later received DBS, the combined levodopa‐tDCS response accounted for DBS outcomes (p = 0.02). These findings suggest that targeted tDCS enhances levodopa effects and may be of potential use to optimize DBS candidate selection.https://doi.org/10.1002/acn3.70073deep brain stimulationmovement disordersparkinson's diseasetranscranial direct current stimulation
spellingShingle Lukas L. Goede
Patricia Zvarova
Bahne H. Bahners
Andreas Horn
Patient Selection in Deep Brain Stimulation: A Role for Transcranial Direct Current Stimulation to Enhance the Levodopa Challenge?
Annals of Clinical and Translational Neurology
deep brain stimulation
movement disorders
parkinson's disease
transcranial direct current stimulation
title Patient Selection in Deep Brain Stimulation: A Role for Transcranial Direct Current Stimulation to Enhance the Levodopa Challenge?
title_full Patient Selection in Deep Brain Stimulation: A Role for Transcranial Direct Current Stimulation to Enhance the Levodopa Challenge?
title_fullStr Patient Selection in Deep Brain Stimulation: A Role for Transcranial Direct Current Stimulation to Enhance the Levodopa Challenge?
title_full_unstemmed Patient Selection in Deep Brain Stimulation: A Role for Transcranial Direct Current Stimulation to Enhance the Levodopa Challenge?
title_short Patient Selection in Deep Brain Stimulation: A Role for Transcranial Direct Current Stimulation to Enhance the Levodopa Challenge?
title_sort patient selection in deep brain stimulation a role for transcranial direct current stimulation to enhance the levodopa challenge
topic deep brain stimulation
movement disorders
parkinson's disease
transcranial direct current stimulation
url https://doi.org/10.1002/acn3.70073
work_keys_str_mv AT lukaslgoede patientselectionindeepbrainstimulationarolefortranscranialdirectcurrentstimulationtoenhancethelevodopachallenge
AT patriciazvarova patientselectionindeepbrainstimulationarolefortranscranialdirectcurrentstimulationtoenhancethelevodopachallenge
AT bahnehbahners patientselectionindeepbrainstimulationarolefortranscranialdirectcurrentstimulationtoenhancethelevodopachallenge
AT andreashorn patientselectionindeepbrainstimulationarolefortranscranialdirectcurrentstimulationtoenhancethelevodopachallenge