Compared with the findings in pre-DBS imaging, <sup>18</sup>F-fluoro-2-deoxy-d-glucose uptake increased in the cerebellum, while according to dopamine transporter imaging, there were no significant differences in the bilateral caudate nucleus and putamen.<h4>Conclusion</h4>Multi-target acute stimulation (DN DBS and GPi DBS) in SCA3/MJD can mildly improve cerebellar ataxia and dystonia and increase cerebellar metabolism. Here, SLC6A3 is linked to Machado-Joseph disease.