Remote Versus In-Person Follow-up Programming After Subthalamic Deep Brain Stimulation for Parkinson's Disease: A Multicenter Randomized Noninferiority Trial
In brief
Remote programming met 5-point noninferiority margin for Parkinson's motor outcomes
In a 52-person trial, remote follow-up programming after initial in-person setup met the prespecified noninferiority margin for motor outcomes at 90 days compared with in-person follow-up. Other clinical and patient-reported outcomes were broadly comparable, with similar serious adverse event rates. The small trial supports short-term use, but longer-term safety and effectiveness remain unknown.
- Journal
- Movement disorders : official journal of the Movement Disorder Society (Q1)
- Published
- 23 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Juhi Shaik, Weidong Zhang, Verena Zentsch, Carsten Buhmann, Ute Hidding, Thomas M Kinfe, et al.
- PMID
- 42920097
- DOI
- 10.1002/mds.70575
Why clinicians should know about it
- Picked for Neurology (clinical) (paper of the day, 25 October 2026): Randomized noninferiority trial of remote Parkinson’s DBS programming
Abstract
BACKGROUND: Remote programming of deep brain stimulation may improve access to specialized postoperative care for people with Parkinson's disease, but prospective randomized evidence remains limited. OBJECTIVE: We aimed to determine whether remote follow-up programming after standardized inpatient initiation is noninferior to conventional in-person follow-up programming for motor outcomes during the early postoperative period. METHODS: In this prospective, randomized, open-label, multicenter noninferiority trial, adults with idiopathic Parkinson's disease who recently underwent bilateral subthalamic nucleus deep brain stimulation implantation at six German centers were randomly assigned 1:1 to conventional in-person follow-up programming or remote follow-up programming through a secure telemedicine platform during the first 90 days after surgery. All participants underwent initial in-person postoperative programming before randomization. The primary outcome was the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III score at 90 days in the medication on and stimulation ON state. The prespecified noninferiority margin was 5 points. RESULTS: Fifty-two participants were randomly assigned. The per-protocol population included 26 participants in the conventional care group and 22 in the remote programming group. The between-group median difference of the primary endpoint was -2.5 points (95% confidence interval, -9.0 to 2.0), meeting the prespecified noninferiority criterion. Secondary clinical outcomes and patient-reported outcomes were broadly comparable between groups. Serious adverse events occurred at similar frequencies in both groups, and no deaths occurred. CONCLUSIONS: Remote follow-up programming after standardized inpatient initiation achieved motor outcomes noninferior to conventional in-person follow-up during the first 3 months, with no clear short-term safety signal. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.