Category: Surgical Therapy: Parkinson's Disease
Objective: Here we present our initial experience with deep brain stimulation therapy (DBS) for Parkinson’s disease (PD) using the closed-loop system.
Background: Although DBS is one of the effective treatments for advanced-stage PD, limitations in the effect of DBS in improving motor symptoms and some side effects associated with stimulation have been reported. Adaptive DBS (aDBS) is a novel strategy that uses a closed-loop system to modulate stimulation based on local field potentials (LFPs) recorded from the DBS electrode. In PD patients, beta oscillations are known to be observed in the subthalamic nucleus (STN) and globus pallidus interna as motor symptoms worsen. Adjusting the stimulation intensity according to the beta band power is expected to reduce battery consumption and the side effects of stimulation. In Japan, clinical use of aDBS started about 18 months ago, ahead of the rest of the world. In this presentation, we will report on our initial clinical experience.
Method: We try to introduce aDBS at least 6 months after electrode implantation, and have tried to introduce aDBS in 10 patients who have had electrodes implanted in the STN. The success or failure of aDBS introduce, the frequency used for sensing, and the tolerability of aDBS were retrospectively evaluated in 10 patients who attempted aDBS introduce.
Results: In LFPs recorded at 7 of the 20 electrodes in the STN, there was no decrease in beta power with increased stimulus intensity or improved motor function. Therefore, aDBS could not be introduced at these electrodes. The median value of the frequency used for sensing was 16.6 Hz (10.74 – 28.32 Hz). Currently, the average follow-up period after aDBS implementation is 3 months, with 2 out of 10 patients returning to continuous DBS (cDBS) settings, and 2 patients using both aDBS and cDBS depending on the situation. The remaining six patients continue to use aDBS at all times.
Conclusion: About 60% of the electrodes were able to implement aDBS, and about 80% of the patients were able to set up a useful aDBS. The low beta band was used primarily for aDBS sensing. Long-term effects will be evaluated in the future.
To cite this abstract in AMA style:
N. Tani, S. Oshino, K. Hosomi, H. Khoo, Y. Fujita, T. Emura, S. Miura, Y. Kimotto, T. Matsuhashi, X. He, A. Reza, T. Yanagisawa, H. Kishima. A Report from Japan on Initial Experiences with Adaptive Deep Brain Stimulation Therapy for Patients with Advanced Parkinson’s Disease [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/a-report-from-japan-on-initial-experiences-with-adaptive-deep-brain-stimulation-therapy-for-patients-with-advanced-parkinsons-disease/. Accessed June 15, 2025.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/a-report-from-japan-on-initial-experiences-with-adaptive-deep-brain-stimulation-therapy-for-patients-with-advanced-parkinsons-disease/