Theta deep-brain stimulation improves cognitive performance in Parkinson’s patients with cognitive impairments

Rachel C. Cole; James F. Cavanagh; Qiang Zhang; Christopher L. Groth; Juan Vivanco-Suarez; Arturo I. Espinoza; Jeremy D. Greenlee; Nandakumar S. Narayanan

doi:10.1038/s41531-026-01529-y

Back

Theta deep-brain stimulation improves cognitive performance in Parkinson’s patients with cognitive impairments

Journal article

Open access

Peer reviewed

Theta deep-brain stimulation improves cognitive performance in Parkinson’s patients with cognitive impairments

Rachel C. Cole, James F. Cavanagh, Qiang Zhang, Christopher L. Groth, Juan Vivanco-Suarez, Arturo I. Espinoza, Jeremy D. Greenlee and Nandakumar S. Narayanan

NPJ Parkinson's Disease

08/14/2026

DOI: 10.1038/s41531-026-01529-y

Files and links (1)

url

https://doi.org/10.1038/s41531-026-01529-yView

Published (Version of record) Open Access

Abstract

Patients with Parkinson’s disease (PD) can experience cognitive impairments linked to low frequency “theta” 4 Hz cortical activity and cognitive control. Our study investigated effects of 4 Hz subthalamic nucleus (STN) deep brain stimulation (DBS) on cognitive performance in PD patients with cognitive impairments. We recruited 17 PD participants with (n = 10) and without (n = 7) cognitive impairment. We compared motor and cognitive performance during 4 Hz STN DBS, typical DBS for motor symptoms of PD (~130 Hz) and DBS OFF. Motor performance was tested by Part III of the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS-III). Cognitive performance was tested by the Multi-Source Interference Task (MSIT), which requires conflict resolution to respond accurately. Motor function improved with 4 Hz STN DBS and further improved with ~130 Hz STN DBS. Compared to DBS OFF, reaction times were decreased during 4 Hz STN DBS and were further decreased at ~130 Hz. Strikingly, 4 Hz DBS alone improved accuracy compared to DBS OFF and ~130 Hz STN DBS. These data suggest that 4 Hz STN stimulation can improve performance in PD patients with cognitive impairments. Our findings will guide therapies targeted at improving cognition in PD and could broaden low-frequency stimulation interventions.

Details

Title: Subtitle: Theta deep-brain stimulation improves cognitive performance in Parkinson’s patients with cognitive impairments
Creators: Rachel C. Cole - University of Minnesota
James F. Cavanagh - University of New Mexico
Qiang Zhang - University of Iowa
Christopher L. Groth - University of Iowa
Juan Vivanco-Suarez - University of Iowa
Arturo I. Espinoza - Des Moines University
Jeremy D. Greenlee - University of Iowa, Iowa Neuroscience Institute
Nandakumar S. Narayanan - University of Iowa
Resource Type: Journal article
Publication Details: NPJ Parkinson's Disease
DOI: 10.1038/s41531-026-01529-y
ISSN: 2373-8057
eISSN: 2373-8057
Publisher: Springer Nature
Language: English
Electronic publication date: 08/14/2026
Academic Unit: Neurology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
Record Identifier: 9985219320002771

Metrics

1 Record Views