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The timing of deep brain stimulation (DBS) surgery is a critical factor in preserving cognitive function for Parkinson's disease patients with a specific genetic mutation, according to a new study by an international team of researchers.

The findings, published in Movement Disorders, offer new guidance for doctors and patients navigating decisions surrounding Parkinson's treatment.

The team was co-led by Dr. Gian Pal, chief of neurology and director of the Movement Disorders Program at Hackensack Meridian Neuroscience Institute at JFK University Medical Center, and associate professor of neurology at the Hackensack Meridian School of Medicine.

Deep brain stimulation is a surgical procedure that acts like a pacemaker for the brain, offering relief from disabling tremors, stiffness and involuntary movements when standard medications work unreliably or no longer work.

DBS uses a surgically implanted battery to send steady, mild electrical pulses to the specific areas affected by Parkinson's. These rhythmic pulses act like noise-canceling headphones, overriding the chaotic brain signals that cause tremors and stiffness so patients can move smoothly again.

Patients who carry a mutation in the GBA1 gene—the most common genetic risk factor for Parkinson's disease—often experience significant physical symptoms earlier in life, making them prime candidates for DBS, but are also predisposed to cognitive problems.

Because of their vulnerability to cognitive problems, doctors have started to approach DBS cautiously in people with Parkinson's disease carrying GBA1 mutations.

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