Brain signals from daily life may sharpen Parkinson's stimulation

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Subjects will be 18 and over * Clinical diagnosis of idiopathic Parkinson's disease (PD), consistent with MDS diagnostic criteria * Motor fluctuations in response to medication * Bilateral subthalamic nucleus (STN) DBS using a commercial sensing-enabled device * Stable cDBS settings for ≥3 months prior to enrollment * Stable antiparkinsonian medication regimen for ≥4 weeks prior to enrollment * Capacity to provide informed consent * Ability and willingness to complete study visits and at-home monitoring * For Part 2: Presence of an adequate STN neural signal (e.g., stable LFP feature suitable for biomarker extraction) during screening * Ability to speak and understand English sufficiently to provide informed consent and complete study procedures and assessments without an interpreter. Exclusion Criteria: * Atypical or secondary parkinsonism (e.g., multiple system atrophy, progressive supranuclear palsy, vascular parkinsonism) * Prior brain surgery other than STN DBS * Clinically significant cognitive impairment or dementia, defined as MoCA \< 24 or equivalent, or lacking capacity to provide informed consent * Active psychiatric illness that could compromise safety or participation (e.g., uncontrolled depression, psychosis, severe anxiety disorder) * History of suicidality or suicide attempt within the past year * Clinically unstable medical conditions (e.g., uncontrolled hypertension, advanced cardiac or pulmonary disease) that would increase study risk * Current substance abuse or dependence * Ongoing participation in another interventional trial that could confound outcomes * Pregnancy or plans to become pregnant during the study period * Inability or unwillingness to comply with study procedures (e.g., at-home monitoring, study visits, data collection)