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@ARTICLE{Off:285817,
      author       = {Off, Johannes and Scherer, Maximilian and Peschke, Sophia
                      and Kirschner, Angelina and Zhang, Weidong and Shaik, Juhi
                      and Dong, Jing and Mehrkens, Jan-Hinnerk and Kaufmann,
                      Elisabeth and Koeglsperger, Thomas},
      title        = {{P}sychometric reliability of patient-reported visual
                      analogue scales in subthalamic nucleus deep brain
                      stimulation programming for {P}arkinson's disease.},
      journal      = {Brain communications},
      volume       = {8},
      number       = {2},
      issn         = {2632-1297},
      address      = {[Oxford]},
      publisher    = {Oxford University Press},
      reportid     = {DZNE-2026-00353},
      pages        = {fcag100},
      year         = {2026},
      abstract     = {Subthalamic nucleus deep brain stimulation is an
                      established therapy for Parkinson's disease, yet its
                      programming relies heavily on subjective patient feedback.
                      Visual analogue scales have been proposed to structure
                      patient-reported outcome measures during programming, but
                      their psychometric reliability has not been systematically
                      evaluated. In this study, fifteen patients with bilateral
                      subthalamic nucleus deep brain stimulation completed four
                      structured experiments to assess the reliability of visual
                      analogue scales: test-retest consistency, the effect of
                      stimulation duration (15, 60, 120 s), the impact of
                      unilateral deep brain stimulation withdrawal intervals (0,
                      10, 30 min), and contralateral stimulation ON versus OFF.
                      Across all experiments, patients provided over 3000 visual
                      analogue scale ratings, which were analyzed using
                      correlation, regression, and Bland-Altman methods, with
                      subgroup analyses examining motor phenotype, cognition, and
                      disease burden. Visual analogue scale ratings demonstrated
                      strong test-retest reliability (r = 0.70, R 2 = 0.53), with
                      $83\%$ of repeated scores within ±2 points. Reliability was
                      lower in patients with tremor-onset compared to non-tremor
                      onset (P = 0.04) but was unaffected by cognitive status or
                      quality of life. Stimulation duration influenced absolute
                      scores, with 15 s ratings systematically lower than 60-120 s
                      (P < 0.001), though relative scaling was preserved. Deep
                      brain stimulation withdrawal intervals did not affect group
                      means but increased trial-level variability, while
                      contralateral stimulation ON versus OFF showed modest
                      correspondence (r = 0.31, R 2 = 0.13), suggesting
                      hemispheric interactions in subjective perception. These
                      findings indicate that visual analogue scale ratings provide
                      reproducible and quantifiable feedback during subthalamic
                      nucleus deep brain stimulation programming. Exploratory
                      analyses suggest that reliability may vary with motor
                      phenotype, stimulation duration, and bilateral context.
                      Incorporating structured visual analogue scale feedback
                      could enhance programming workflows, support remote care
                      models, and inform future multimodal closed-loop deep brain
                      stimulation strategies.},
      keywords     = {Parkinson’s disease (PD) (Other) / deep brain stimulation
                      (DBS) (Other) / visual analogue scale (VAS) (Other)},
      cin          = {Clinical Research (Munich)},
      ddc          = {610},
      cid          = {I:(DE-2719)1111015},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41924696},
      pmc          = {pmc:PMC13037577},
      doi          = {10.1093/braincomms/fcag100},
      url          = {https://pub.dzne.de/record/285817},
}