Case Report: Chronic Adaptive Deep Brain Stimulation Personalizing Therapy Based on Parkinsonian State

Area of Science:

• Neurology
• Biomedical Engineering

Background:

• Parkinson's disease (PD) management often involves addressing motor fluctuations.
• Deep brain stimulation (DBS) is a therapeutic option for advanced PD.
• Adaptive DBS (aDBS) offers potential for more personalized neuromodulation.

Observation:

• A 51-year-old male patient with PD and motor fluctuations underwent bilateral subthalamic nucleus DBS using an adaptive device (Percept™ PC).
• The adaptive DBS device delivered stimulation based on real-time local field potential (LFP) oscillations.
• Local field potential fluctuations were less pronounced within the hospital environment compared to outside settings.

Findings:

• The aDBS system effectively adapted stimulation to beta oscillation fluctuations.
• No stimulation-induced side effects were observed during the adaptive DBS phase.
• The device demonstrated feasibility in delivering condition-dependent stimulation.

Implications:

• This case highlights the potential of adaptive DBS for tailored PD treatment.
• The findings offer new insights into the pathophysiology of Parkinson's disease.
• Condition-dependent neuromodulation may improve therapeutic outcomes in movement disorders.