Long-Term Personalized Adaptive Deep Brain Stimulation in Parkinson Disease: A Nonrandomized Clinical Trial

Area of Science:

• Neurology
• Biomedical Engineering

Background:

• Adaptive deep brain stimulation (aDBS) offers automated amplitude adjustment based on neural activity for Parkinson disease (PD).
• The long-term safety and efficacy of at-home aDBS for PD patients remain under investigation.

Purpose of the Study:

• To assess the tolerability, efficacy, and safety of long-term aDBS in PD patients previously stable on continuous DBS (cDBS).

Main Methods:

• An international, open-label, prospective trial involved 68 PD participants.
• Participants underwent a single-blind crossover evaluation of two aDBS modes (ST-aDBS and DT-aDBS) followed by an optional 10-month long-term follow-up.
• Primary endpoint: on-time without troublesome dyskinesias; Secondary endpoint: total electrical energy delivered (TEED).

Main Results:

• The primary endpoint performance goal was met by 91% of participants with DT-aDBS and 79% with ST-aDBS.
• ST-aDBS showed a significant reduction in TEED compared to cDBS (-15%).
• No serious device-related adverse events were reported during long-term follow-up; exploratory analyses suggested improved on-time without dyskinesias with DT-aDBS.

Conclusions:

• Long-term at-home aDBS is a tolerable, effective, and safe therapy for PD patients.
• aDBS demonstrates potential for improved symptom management and reduced energy delivery in PD treatment.
• Further research supports the clinical utility of aDBS in managing Parkinson disease.