Patient Selection in Deep Brain Stimulation: A Role for Transcranial Direct Current Stimulation to Enhance the Levodopa Challenge?
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.
Authors
- Bahne H. Bahners (ORCID: https://orcid.org/0000-0003-1963-9798)
- Andreas Horn (ORCID: https://orcid.org/0000-0002-0695-6025)
- Lukas L. Goede (ORCID: https://orcid.org/0000-0001-6026-185X)
- Patricia Zvarova (ORCID: https://orcid.org/0009-0004-7831-8796)
Institutions
- Brigham and Women's Hospital (US)
- Harvard University (US)
- Humboldt-Universität zu Berlin (DE)
- Massachusetts General Hospital (US)
- Circuit Therapeutics (United States) (US)
- Center for Neuro-Oncology (US)
- University Hospital Cologne (DE)
- Einstein Center for Neurosciences Berlin (DE)
- Freie Universität Berlin (DE)
- Charité - Universitätsmedizin Berlin (DE)
Publication Details
- Journal
- Annals of Clinical and Translational Neurology
- Published
- 2025-05-19
- DOI
- https://doi.org/10.1002/acn3.70073
- Primary Topic
- Neurological disorders and treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- EU Joint Programme – Neurodegenerative Disease Research
- Deutsche Forschungsgemeinschaft
- Thiemann Stiftung
- National Institutes of Health