Deep Brain Stimulation Window May Matter for Parkinson’s Patients With GBA1 Variants

Patients with GBA1 gene variants may develop significant physical symptoms earlier in life while also facing greater vulnerability to cognitive problems. This combination can complicate decisions about when to consider deep brain stimulation. New findings now suggest that the timing of deep brain stimulation may influence memory and executive function outcomes in this genetically predisposed group.

The study was led by an international research team with involvement from Hackensack Meridian Neuroscience Institute (Hackensack, NJ, USA) at JFK University Medical Center and Hackensack Meridian School of Medicine. The work focused on deep brain stimulation, or DBS, a surgical therapy that functions like a pacemaker for the brain. DBS uses an implanted battery to deliver steady, mild electrical pulses to specific brain areas affected by Parkinson’s disease. These pulses help override abnormal brain signals that contribute to tremor, stiffness and involuntary movement.

Researchers analyzed data from 343 patients treated across 10 medical centers in the United States and Europe. They compared cognitive outcomes over time in patients with and without GBA1 mutations. The analysis also examined whether DBS was performed early or late in the course of Parkinson’s disease. The findings were published in Movement Disorders on October 1, 2026.

The results showed that cognitive risk in GBA1 mutation carriers was strongly linked to surgical timing. Patients with the mutation who received DBS later in their disease course had a significantly faster decline in cognitive abilities than those treated earlier. Among patients without the mutation, DBS timing did not affect cognitive outcomes. The data identified the first seven to eight years after Parkinson’s diagnosis as an important window for intervention.

The findings support earlier genetic testing as part of DBS evaluation in Parkinson’s disease. Identifying GBA1 status earlier could help patients and clinical teams weigh potential motor benefits against cognitive risks. The authors emphasized that a GBA1 variant should not automatically exclude patients from DBS. Instead, genetic information may help guide a more individualized treatment timeline.

“We may be approaching a turning point in how we use deep brain stimulation for Parkinson's disease. For decades, DBS decisions have largely been based on a patient's symptoms and clinical characteristics. Our research suggests that a patient's genetics—and importantly, the timing of surgery—may also matter. The future of DBS may not simply be deciding who should receive it, but identifying the right window to intervene for each individual patient. That moves us closer to truly personalized treatment for Parkinson's disease,” said 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 Hackensack Meridian School of Medicine.

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