Category: Parkinson’s Disease: Clinical Trials
Objective: Describe the preliminary results of adaptive deep brain stimulation (aDBS) treatment for Parkinson’s disease (PD) and the value of real-world monitoring in defining clinical benefit.
Background: Adaptive mode holds the promise of improving DBS treatment through real-time adaptation of stimulation delivery to the patient’s needs. Given the characteristic of aDBS to vary over time, its programming and effectiveness may particularly benefit from prolonged evaluations in a real-world context.
Method: We studied three patients with Parkinson’s disease and subthalamic DBS and directional electrodes (male, age: 59-66 years, disease duration: 9-16 years, days since surgery: 42-62). The patients, blinded to treatment, received cDBS and aDBS for two weeks respectively, in randomised order, and with unchanged drug therapy. Patients were assessed blindly with different scales (MDS-UPDRS, MDS-UDysRs, FOG-Q, etc.). For three days, they filled in Hauser’s diary and were monitored in the real-world for akinetic-rigid symptoms and gait with a wearable device. In aDBS mode, our rechargeable fully implantable pulse generator applies a linear algorithm that changes the stimulation current every minute according to the average amplitude of the local field potential (LFP) calculated in a patient-specific beta frequency range.
Results: All three patients preferred aDBS over cDBS for a better improvement in motor fluctuations. One patient preferred aDBS also for a significant benefit on gait. Evaluations in the clinic were similar between the two stimulation modes. In contrast, real-world monitoring showed for all patients an increase in good-on-time (on time without troublesome dyskinesia) by an average of 2 hours per day. Subthalamic LFP were recorded successfully and correlated with the patient’s daily activities.
Conclusion: Real-world monitoring with inertial sensors can help document the additional benefit of new stimulation paradigms such as aDBS.
To cite this abstract in AMA style:
L. Caffi, R. Habib, L. Borellini, E. Mailland, F. Cogiamanian, M. Arlotti, L. Rossi, S. Bonvegna, C. Palmisano, S. Marceglia, A. Priori, G. Pezzoli, M. Locatelli, IU. Isaias. Long term real-world monitoring supports the superiority of adaptive deep brain stimulation: preliminary data on three patients with Parkinson’s disease [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/long-term-real-world-monitoring-supports-the-superiority-of-adaptive-deep-brain-stimulation-preliminary-data-on-three-patients-with-parkinsons-disease/. Accessed November 20, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-real-world-monitoring-supports-the-superiority-of-adaptive-deep-brain-stimulation-preliminary-data-on-three-patients-with-parkinsons-disease/