Cognitive effects of adaptive deep brain stimulation in Parkinson's disease: stability without risk

Adaptive deep brain stimulation (aDBS) is a closed-loop system that adjusts stimulation based on patient biomarkers. This study evaluated the cognitive safety of aDBS in Parkinson's disease (PD).

Sixteen PD patients with bilateral subthalamic DBS underwent cognitive assessments (attention, language, memory) 6 days post-surgery during an 8 h protocol. Testing occurred at five time points: T1 (aDBS, medication "off"), T2/T4 (aDBS, medication "on"), and T3/T5 (aDBS "on", medication "off"). Four patients followed the same protocol with continuousDBS (cDBS).

Results showed no cognitive fluctuations in aDBS patients (p ≥ 0.110). However, cDBS patients exhibited significant reaction time (RT) variations (p = 0.019), with RTs lower at T1 than T3 (p = 0.011) and T5 (p = 0.021), and at T4 compared to T2 (p = 0.002).

These findings suggest that 8 h aDBS may not adversely affect cognitive performance, providing preliminary evidence of its cognitive safety and stability in PD.