Background Clinically relevant anxiety can be detected in patients with amyotrophic lateral sclerosis (ALS), but its prevalence and determinants have not yet been fully assessed. Aims This study aimed at assessing the prevalence and clinical underpinnings of anxiety in ALS. Method Non-demented ALS patients (N = 433) and healthy controls (N = 313) were administered the State- and Trait-Anxiety Inventory – Form Y (STAI-Y1 for state-anxiety and STAI-Y2 for trait-anxiety) and the Beck Depression Inventory (BDI). Patients were further assessed for cognition (Edinburgh Cognitive and Behavioural ALS Screen), behaviour (Frontal Behavioural Inventory) and motor status (disease duration, ALS Functional Rating Scale-Revised and progression rate). The prevalence of clinically significant state- and trait-anxiety were estimated by applying age-stratified cut-offs to STAI-Y1/-Y2 t-scores. Linear and logistic regressions were run to test the determinants of STAI-Y1/-Y2 scores. Results STAI-Y1 and -Y2 scores above cut-off were detected in 18.2 and 13.9% of patients, respectively – with proportions being higher in cases versus controls (ps < 0.001). BDI, but neither cognitive/behavioural nor motor variables, was identified as a significant predictor of STAI-Y1/-Y2 scores (ps < 0.003). The cognitive–affective subscale of BDI was the sole predictor of scores above cut-off on both STAI-Y1 and STAI-Y2 (ps < 0.001). Conclusions Clinically significant levels of state- and trait-anxiety occur in ∼18 and ∼14% of non-demented ALS patients, respectively, mostly driven by cognitive and affective facets of depression, and are independent of motor and cognitive/behavioural features.

The application of artificial intelligence (AI) in medicine presents unprecedented potential but challenges traditional notions of human identity and medical ethics. Through a systematic literature review and thematic analysis of the interdisciplinary conference “Minds and Machines”, we examine the transformative impact of AI on medical practice, consciousness, and human enhancement considering the clinical, ethical, and regulatory contexts. Successful integration of AI requires a delicate balance between innovation and safeguarding the human component in healthcare through robust ethical frameworks, enhanced medical education, and person-centered implementation.

Adaptive deep brain stimulation (aDBS) is a closed-loop system that adjusts stimulation based on patient biomarkers. This study evaluated the cognitive safety of aDBS in Parkinson’s disease (PD). Sixteen PD patients with bilateral subthalamic DBS underwent cognitive assessments (attention, language, memory) 6 days post-surgery during an 8 h protocol. Testing occurred at five time points: T1 (aDBS, medication “off”), T2/T4 (aDBS, medication “on”), and T3/T5 (aDBS “on”, medication “off”). Four patients followed the same protocol with continuousDBS (cDBS). Results showed no cognitive fluctuations in aDBS patients (p ≥ 0.110). However, cDBS patients exhibited significant reaction time (RT) variations (p = 0.019), with RTs lower at T1 than T3 (p = 0.011) and T5 (p = 0.021), and at T4 compared to T2 (p = 0.002). These findings suggest that 8 h aDBS may not adversely affect cognitive performance, providing preliminary evidence of its cognitive safety and stability in PD.

Motor side effects may emerge after deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson’s disease (PD) patients. Out of 60 PD patients, we observed 16 patients displaying de novo dystonic symptoms after the implantation and 11 dystonic PD patients without benefit from the stimulation. We hypothesized that a common neural pathway may cause dystonia in both conditions. Our study aims to investigate the clinical and connectivity substrates of dystonia after STN-DBS. We divided our cohort into four groups: 16 patients displaying dystonia after STN-DBS, 11 patients with previously known dystonia not improving after surgery, 14 patients with dystonic symptoms relieved by the stimulation and 19 controls who never experienced dystonia. MANOVA was used to compare clinical data and the distance of the active contact center from the STN border among the four groups. Finally, we reconstructed the “sour” spots for dystonic symptoms and the associated structural and functional connectivity using a Parkinsonian normative connectome. De novo dystonic and not-improved dystonic patients had a statistically significant longer PD duration before surgery (p = 0.001) and a greater active contact-STN distance (p < 0.001). Moreover, the “sour” spots were similar in both groups and structural and functional connectivity profiles were associated with brain areas correlated with dystonia pathophysiology (cerebellum, midbrain, parietal and temporal cortices). We formulated a two-hit model for dystonia after STN-DBS: a clinical feature of Parkinsonian patients causes predisposing altered plasticity contributing to dystonic symptoms development when coupled with the stimulation of dystonia-related subcortical and cortical structures.

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established treatment for advanced Parkinson’s disease (PD), often leading to positive motor and non-motor outcomes. While objective motor improvements after DBS are well documented, less is known about how patients and all those involved in their care perceive these benefits on a subjective level. The primary aim of the study was to investigate the perception gap between patients, caregivers, and treating neurologists regarding DBS physical and psychological benefits in PD and their correlates. 25 PD patients (age 58.9 ± 8.0 years; 9 women) who underwent bilateral STN-DBS, along with their caregivers and neurologists, rated perceived psychological and physical improvements 6 months after surgery using a two-item Visual Analogue Scales (VAS, 0–10). Intraclass correlation coefficients (ICC [95

Background Adaptive deep brain stimulation (aDBS) is becoming a real therapeutic option for patients candidate to DBS, and implantable devices are now commercially available. Here we present the results of a blinded randomized cross-over pilot trial aimed at comparing aDBS with conventional DBS (cDBS). Methods Fifteen patients were implanted with the AlphaDBS device (Newronika SpA, Milan, Italy, [NCT04681534][1]). In 11 patients, the device replaced a previous Medtronic Activa PC at battery depletion, while the others were four first-time implant patients. Patients underwent two study phases, a short-term follow up (ST-FUP) in the hospital in which the patient received aDBS and cDBS for one day each (in random order), and a 1-month long-term follow-up phase (LT-FUP), with the patient at home treated for two weeks in each DBS mode. The primary endpoint was safety, measured as the occurrence of stimulation-related adverse events. Secondary outcomes regarded effectiveness measured through the UPDRS-III and the UDysRS scales used in clinical setting, and a 3-day diary used for home assessment to estimate good on time (GOT, ON time without troublesome dyskinesia). At the end of the study period, patients blindly decided their preferred stimulation mode and whether or not to keep the investigational device thus entering an open label extension phase. Findings No aDBS-related adverse events were reported. The AlphaDBS device reliably recorded deep brain signals and applied a linear algorithm that changed the stimulation current every minute based on the average local field potential amplitude calculated in a patient-specific beta frequency range. In the ST-FUP, aDBS improved patients as much as cDBS, with lower UDysRS scores. In the LT-FUP, considering intra-patient individual difference, aDBS provided greater benefit than cDBS in 80% of patients. The same percentage of patients preferred and continued with aDBS to date. Interpretation These results suggest that aDBS is safe and effective and can be applied in a large population of parkinsonian patients who are candidate for DBS. aDBS improves more than cDBS the majority of patients and it is also subjectively preferred by them in the long term. Further research is needed to better understand the profile of the best responders and the scheduling of aDBS. ### Competing Interest Statement SM, AP, LR, ML, FC, SB, FT, GF are founders and shareholders of Newronika SpA. II, E.M. is member of the scientific advisory board of Newronika SpA, J.V. is member of the scientific advisory board of Newronika SpA and works as a consultant to Boston Scientific and Medtronic, and has received honoraria for lectures from Boston Scientific and Medtronic as well as research grants from Boston Scientific and Medtronic, A.M.L. is member of the scientific advisory board of Newronika SpA, has served as a consultant for Boston Scientific, Medtronic, Aleva, and Abbott and is a co-founder of Functional Neuromodulation. ### Clinical Trial [NCT04681534][1] ### Clinical Protocols ### Funding Statement The study was sponsored by Newronika SpA ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Bioethics Committee at National Oncology Institute of Maria Skłodowska-Curie, National Research Institute in Warsaw; Comitato Etico Milano Area 2; Comitato Etico IRCCS Istituto Neurologico C. Besta; Comitato Etico interaziendale AOUC Citta della Salute e della Scienza, AO Ordine Mauriziano di Torino, ASL Citta di Torino gave ethical approval for this work I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04681534&atom=%2Fmedrxiv%2Fearly%2F2025%2F02%2F24%2F2025.02.20.25322374.atom

Introduction Deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves motor functions in patients with Parkinson’s disease (PD) but may cause a decline in specific cognitive domains including executive processes and language.The aim of this study was to derive standardized regression-based (SRB) reliable change indices (RCIs) in an Italian cohort of Parkinson's patients undergoing STN-DBS to detect clinically meaningful variations in verbal fluency (VF) one year after surgery define. Methods Before (T0) and 12 months after (T1) surgery, 36 PD patients who underwent bilateral STN-DBS were evaluated with the Alternate Verbal Fluency Battery (AVFB), including phonemic (PVF), semantic (SVF) and alternate VF tests (AVF) and a composite shifting index (CSI). At T0, motor status was assessed using the Unified Parkinson's Disease Rating Scale-III (UPDRS-III) and L-dopa equivalent daily dose was recorded. Results Group-level declines were limited to PVF and SVF scores. Applications of these RCIs revealed idiosyncratic patterns of longitudinal trends that differed from those at the group level. Indeed, when looking at individual performances, no clustered pattern of decline or improvement could be visibly detected. The UPDRS-III predicted T1 AVF and CSI scores. Conclusion Our study provides Italian practitioners and researchers with SRB-RCIs to detect meaningful differences in the VF performance of PD patients undergoing STN-DBS one year after surgery. Variables associated with postoperative cognitive changes can be used in future studies to develop multivariable predictive models to support clinical decision making and patient counselling.

OBJECTIVE:Creativity is the ability to generate original ideas, solutions and new concepts. This includes divergent thinking, defined as the ability to think outside of established patterns. Research has focused on the link between creativity and schizophrenia, but results are heterogeneous and contradictory. This study examined divergent thinking using the Divergent Thinking Test (DTT), which compared healthy subjects and subjects with a psychiatric disorder, including schizophrenia. METHODS:48 Patients (schizophrenia, n = 20, psychiatric disorder other than schizophrenia, n = 28) and 38 healthy subjects performed the DTT, which includes five factor scores: fluidity (FL), flexibility (FS), originality (O), elaboration (E), title (T). Linear models were employed for between-group comparisons. RESULTS:The results indicated that psychiatric patients show a lower performance on the DTT than healthy subjects. Within the patient group, subjects with schizophrenia show greater difficulties than subjects with other psychiatric disorders. CONCLUSIONS:The DTT scores of the control group are higher than those of the psychiatric group. Regarding to the type of diagnosis, performance on the DTT task is lower in schizophrenic patients than in patients with another psychiatric disorder, suggesting the existence of a negative association between creativity and schizophrenia.

The authors communicate that the STXBP1 pathogenic variant of the patient described in the article [[1]Dilena R. Striano P. Traverso M. Viri M. Cristofori G. Tadini L. et al.Dramatic effect of levetiracetam in early-onset epileptic encephalopathy due to STXBP1 mutation.Brain Dev. 2016; 38: 128-131Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar] is not c.[922A>T], p.[Lys308(∗)] but rather c.704G>A, p.Arg235Gln, which is predicted to be probably pathogenetic by in silico analysis and it has been also reported in another STXBP1 patient (case decipher ID#258815) [[2]Suri M. Evers J.M.G. Laskowski R.A. O'Brien S. Baker K. Clayton-Smith J. et al.Protein structure and phenotypic analysis of pathogenic and population missense variants in STXBP1.Mol Genet Genomic Med. 2017; 5: 495-507Crossref PubMed Scopus (22) Google Scholar]. The correct pathogenic variant should be amended in the abstract (patient description) as well as in the text (2. Case description, last paragraph). The authors apologize for this mistake. Dramatic effect of levetiracetam in early-onset epileptic encephalopathy due to STXBP1 mutationBrain and DevelopmentVol. 38Issue 1PreviewSyntaxin Binding Protein 1 (STXBP1) mutations determine a central neurotransmission dysfunction through impairment of the synaptic vesicle release, thus causing a spectrum of phenotypes varying from syndromic and non-syndromic epilepsy to intellectual disability of variable degree. Among the antiepileptic drugs, levetiracetam has a unique mechanism of action binding SV2A, a glycoprotein of the synaptic vesicle release machinery. Full-Text PDF

Dystonia is a movement disorder in which sustained muscle contractions give rise to abnormal postures or involuntary movements. It is a disabling and disfiguring disorder that affects activities of daily living and gives people a bizarre appearance often associated with psychological morbidity, embarrassment and social avoidance. Intramuscular injection of botulinum toxin (BoNT) is the most effective treatment for motor symptoms in focal dystonia, but little is known about its impact on the psycho-social dimension. The main aim of this study was to evaluate psycho-social changes in patients with focal dystonia after starting BoNT treatment using self-reported scales. The Beck Depression Inventory (BDI-II), the 36-Item Short Form Health Survey (SF-36), the Body Uneasiness Test (BUT), the State-Trait Anxiety Inventory (STAI) and the Visual Analogue Scale (VAS) assessing body self-image, satisfaction with physical aspects, social avoidance, self-reported depression, and self-distress were completed by 11 patients with dystonia and 9 patients with hyperhidrosis as a control group before BoNT (T0). VAS was then performed after four weeks (T1) to assess whether BoNT induced changes in the psychosocial dimension. Our results showed that only depressive symptoms and rumination about body defects improved in patients with dystonia after BoNT treatment, while improvement in self-distress and satisfaction with physical aspects was also found in hyperhidrosis. Individuals with hyperhidrosis experience poorer psychological well-being and suffer from higher levels of distress compared to dystonic patients. This suggests that individuals with this disabling condition are more vulnerable to social impact than dystonic patients.

OBJECTIVE:We aimed to evaluate epidemiology, seizure type, EEG, and etiology of neonatal seizures (NS) in a tertiary neonatal intensive care unit. METHODS:Data on infants with a neurophysiological confirmation of NS were collected between 2009 and 2022. Seizure types and epileptic syndromes were classified by the ILAE classification and EEG by the Italian Neonatal Seizure Collaborative Network (INNESCO) score. RESULTS:Out of 91,253 neonates, 145 presented with NS; 69.7 % were born at term and 30.3 % were preterm infants. The incidence of NS in neonates born at our center was 1.2 per 1,000 live newborns (96/80697 neonates) while in the entire neonatal population admitted to our center it was 1.6 per 1,000 live births, increasing with lower preterm age. Compared to previous studies, we found a lower proportion of hypoxic-ischemic encephalopathy (HIE) (23.4 %) and a higher rate of genetic contribution (26.2 %). The infection rate was higher in preterm (31.8 %) than in full term (9.9 %) infants. Electrographic seizures were associated with acute provoked seizures (35.9 %), preterm age (52.3 %), and HIE (52.9 %). Vascular etiology was associated with focal clonic seizures (56.8 %). Non-structural neonatal genetic epilepsy was associated with sequential seizures (68.2 %), particularly KCNQ2 and SCN2A epilepsy. Background EEG was abnormal in all HIE, infections (85.7 %) and metabolic NS (83.3 %). In genetic epilepsy, background EEG depended on the epileptic syndrome: normal in 80 % of self-limited neonatal epilepsy and abnormal in 77.8 % of developmental and epileptic encephalopathy. Electroclinical seizures were associated with focal onset, while electrographic seizures correlated with a multifocal onset. CONCLUSIONS:A low incidence of HIE and a high incidence of genetic etiology were observed in our cohort of NS. Seizure type and EEG features are fundamental to address etiology.

The coronavirus disease 2019 (COVID-19) pandemic rapidly boosted the introduction of certain changes in mental healthcare services, consequently driving up the adoption of remote care delivery options. We conducted an online Italian survey to evaluate telepsychology use, attitudes, acceptance, and training needs, as well as to understand patient-professional interactions in video-consultations, aiming to inform future mental healthcare practices and policies. The current study's survey responses were collected using an anonymous, self-reported questionnaire on the ‘REDCap’ platform from 25 October 2022 to 26 July 2023. In total, 128 mental health professionals and 113 patients completed the survey. In our sample, 69 % of patients and 79.7 % of mental health professionals reported having used telepsychology during COVID-19 pandemic; in particular, 84.6 % of patients and 95.1 % of professionals selected video-consultation modality. Data showed that participants expressed high satisfaction with this communication tool. The increase in satisfaction was directly proportional to increase in the quality of interactions and in relation to the quality of the experiences. The critical factors influencing the video-consultation experience include communication style, information completeness, patient-centredness, and the comfort underscoring the central role of the professional-patient relationship, which, substantially, remains a key element in the psychological treatment process. These findings reinforce the need for continued refinement and expansion of telepsychology services, thus highlighting the potential for integrating innovative technologies into mental health practise.

Introduction: The rapid spread of the COVID-19 pandemic has had a significant impact on the psychological well-being of millions of people around the world, and even more so among children. Contracting SARS-CoV-2, resulting in home confinement and restrictions on daily and school activities, led to negative effects on the mental health of the paediatric population. Although children suffering from COVID-19 had milder general symptoms compared to adults, impairments in cognitive, neuropsychological, and emotional-behavioural development were noted. Objective: The main aim of the present study was to detect possible changes in the neuropsychological and emotional-behavioural development of children after infection with the SARS-CoV-2 virus. The second aim was to investigate possible relationships between cognitive abilities and psychosocial characteristics. Methods: A total of 40 patients aged 8–9 years were recruited and divided into two groups: children who contracted (CG) and did not contract (NCG) SARS-CoV-2. The BVN 5–11 (Neuropsychological evaluation battery for developmental age from 5 to 11 years) instrument was administered to assess attention, memory, verbal recall, planning, phonemics, and categorical fluency domains in the paediatric population. Data on changes in emotional-behavioural profile and daily activities were collected through a questionnaire to parents. Results: The Wilcoxon signed-rank test revealed a significant change in mood after the COVID-19 period only in the CG participants (p = 0.019). However, the neuropsychological performance of the two identified groups on BVN 5–11 sub-items was below the cutoff of clinical significance. Correlations were found between sub-items of the BVN 5–11 battery, extracurricular activities, and children’s psycho-motor development. Significant positive correlations were observed between Naming on visual presentation and Reading time (p = 0.006), backward digit span and time of motor activity (p = 0.009), Visual attention and Reading time (p = 0.048), and Phonemic fluency and time observed using devices (p = 0.030). Positive statistically significant correlations were also found between Mood and Free behaviour (p = 0.000), between Mood and Structured behaviour (p = 0.005), and between Mood and peer Interaction (p = 0.013). Conclusions: SARS-CoV-2 infection negatively affected the emotional development of children contracting the virus. The neuropsychological functioning of the paediatric population was influenced by psychosocial variables and time spent on daily activities, which played a protective role in children’s cognitive development.

Background/Objectives: High cognitive reserve (CR) has been shown to have beneficial effects on global cognition, cognitive decline, and risk of dementia in Parkinson’s disease (PD). We evaluated the influence of CR on the long-term cognitive outcomes of patients with PD who underwent subthalamic nucleus deep brain stimulation (STN-DBS). Methods: Twenty-five patients with PD underwent neuropsychological screening using the Montreal Cognitive Assessment (MoCA) at baseline, 1 year, and 5 years after bilateral STN-DBS. CR was assessed using the Cognitive Reserve Index questionnaire. According to CR score, patients were assigned to two different groups (LowCR group ≤ 130, HighCR group > 130). Results: Our data showed that patients in the HighCR group obtained a better performance with the MoCA total score at long-term follow-up compared to those in the LowCR group ([mean ± SE] LowCR group: 21.4 ± 1.2 vs. HighCR group: 24.5 ± 1.3, p = 0.05). The cognitive profile of the HighCR group remained unchanged over time. Conversely, the LowCR group had worse global cognition 5 years after surgery (T0: 25.3 ± 0.6 vs. T2: 21.4 ± 1.2, p = 0.02). Cognitive decline was not associated with mood, demographics, or clinical variables. Conclusions: These preliminary findings suggest that higher CR may be protective in PD cognition after STN-DBS. Specifically, a high CR may help cope with long-term decline in the context of surgical treatment. Quantifying a patient’s CR could lead to more personalized medical care, tailoring postoperative support and monitoring for those at higher risk of cognitive decline.

. The present study aimed at deriving regression-based reliable change indices (RCIs) for the Montreal Cognitive Assessment (MoCA) in an Italian cohort of non-demented Parkinson’s disease (PD) patients. N = 33 consecutive, non-demented PD patients were followed-up at a 5-to-8-month interval (M = 6.6; SD = 0.6) with the MoCA. Practice effects and test-retest reliability were assessed via dependent-sample t-tests and intra-class correlation (ICC) coefficients, respectively. RCIs were derived separately for raw and demographically adjusted MoCA scores according to a standardized regression-based approach by accounting for both baseline confounders (i.e., demographics, disease duration and Unified Parkinson’s Disease Rating Scale scores) and retest interval. No practice effects were found (t(32) = 0.29; p = .778), with acceptable test-retest reliability being detected (ICC = 0.67). MoCA scores at T0 proved to be the only significant predictor of T1 MoCA performances within both the model addressing raw scores and that addressing adjusted scores (ps < 0.001). The present study provides Italian practitioners and researchers with regression-based RCIs for the MoCA in non-demented PD patients, which can be reliably adopted for retest interval ≥ 5 and ≤ 8 months without encountering any practice effect.

Objective Fibromyalgia (FM) is characterised by chronic widespread pain, often associated with fatigue, sleep disturbance, cognitive and mood impairment. Pain is a complex and multidimensional experience that significantly impacts personal, social, and professional functioning. Psychological factors related to chronic pain include catastrophising and self -efficacy in managing the painful condition. Therefore, this study explores the influence of chronic pain and related psychological factors on functional outcomes in FM patients. Methods In this study, 91 Italian patients with FM were assessed using an online questionnaire. The questionnaire included instruments to assess pain, such as the Numerical Rating Scale (NRS) and the Brief Pain Inventory (BPI), psychological characteristics, such as the Pain Self -Efficacy Questionnaire (PSEQ) and the Pain Catastrophizing Scale (PCS), and health -related quality of life with the 12 -item Short Form Survey (SF -12). Multiple regression models were run, using the Interference subscale of the BPI and the physical and mental components of the SF -12 as outcomes, and the NRS, PCS and PSEQ scales as predictors. Results Our analysis revealed that in our model, both PCS and PSEQ were significant predictors of BPI -Interference (PCS: )3=0.29; p=0.001; PSEQ: )3=-0.36; p<0.001); NRS and PSEQ significantly predicted SF -12 -Physical score (NRS: )3=-0.32; p=<0.001; PSEQ: )3=.50; p<0.001); PCS was found to be the only significant predictor of SF -12 -Mental scores ()3=-0.53; p<0.001). Conclusion Our results suggested that psychological variables such as catastrophic thinking and self -efficacy play a significant role in determining daily functioning and physical and mental health status in FM patients, showing greater influence than pain intensity.

Objective. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves motor outcomes in Parkinson's disease (PD) but may have adverse long-term effects on specific cognitive domains. The aim of this study was to investigate the association between total electrical energy (TEED) delivered by DBS and postoperative changes in verbal fluency. Methods. Seventeen PD patients undergoing bilateral STN-DBS were assessed with the Alternate Verbal Fluency Battery (AVFB), which includes phonemic (PVF), semantic (SVF), and alternate verbal fluency (AVF) tests, before surgery (T0) and after 6 (T1) and 12 months (T2). Bilateral TEED and average TEEDM were recorded at T1 and T2. For each AVFB measurement, changes from T0 to T1 (A-01) and from T0 to T2 (A-02) were calculated. Results. At T1, PVF (p = 0.007) and SVF scores (p = 0.003) decreased significantly. TEED measures at T1 and T2 were unrelated to A-01 and A-02 scores, respectively. However, an inverse, marginally significant association was detected between the TEEDM and A-01 scores for the AVF (p = 0.041, against an a adjusted = 0.025). Conclusions. In conclusion, the present reports provide preliminary evidence that TEED may not be responsible or only slightly responsible for the decline in VF performance after STN-DBS in PD.