Peer Review Report For: Greater occipital nerve stimulation for cognitive impairment in Parkinson's disease: A two-stage feasibility and tolerability study [version 1; peer review: 2 approved with reservations]

Background Effective treatments for cognitive impairment in Parkinsons’s disease (PD) are needed, with Greater Occipital Nerve Stimulation (GONS) emerging as a potential therapeutic approach. This study aimed to explore PD patients' attitudes toward GONS and assess its safety and tolerability in an open-label field study. Methods A two-stage study was carried out, comprising an online survey to gather self-reported attitudes from individuals with PD toward GONS as a treatment option, followed by an open-label field study evaluating the safety, tolerability, and acceptability of GONS in PD-MCI patients. Results Of 50 survey participants, 86% expressed willingness to try GONS for cognitive impairment. Five participants completed the GONS intervention, which was found to be safe, well-tolerated, and acceptable Conclusion People with PD are open to novel interventions for cognitive impairment. GONS was shown to be safe and well-tolerated, warranting further investigation as a potential therapeutic approach.