Category: Parkinson's Disease: Surgical Therapy
Objective: To evaluate the specific programming parameters of adaptive deep brain stimulation (aDBS) in Parkinson’s disease (PD) and identify the most effective settings for optimizing therapeutic outcomes.
Background: In patients with PD, characteristic beta-band local field potentials (LFPs) are observed in the cortical and basal ganglia motor-related regions, fluctuating in accordance with motor symptom variations. aDBS, which modulates stimulation automatically based on these fluctuations, has been clinically implemented. However, compared to conventional DBS, aDBS requires multiple programming parameters, increasing the complexity of the settings. Additionally, some patients do not achieve sufficient clinical benefits. This study aimed to analyze the specific parameters used in aDBS programming and determine which settings are most effective.
Method: We analyzed 40 electrodes in 20 patients with advanced PD who underwent DBS using the Medtronic Percept PC/RC system and had been followed for at least six months after aDBS implementation. We examined the selection process for beta-band LFPs used in aDBS, including the timing of measurement, choice of treatment mode, upper and lower threshold settings, stimulation range, temporary suspension values, transition time adjustments, and long-term variations in stimulation parameters.
Results: Beta-band LFPs corresponding to motor symptom fluctuations were successfully recorded in all patients and utilized for aDBS programming. All LFPs were collected within one month postoperatively. Dual-threshold settings were applied in all cases. Upper and lower thresholds were determined using the streaming function in five cases, while clinical symptoms guided threshold selection in 15 cases. In 10 cases, transition time was shortened from the initial setting. Within six months, 17 cases required adjustments to the LFP fluctuation range, and 20 cases required modifications to the stimulation range.
Conclusion: Effective utilization of aDBS requires meticulous programming and frequent parameter adjustments. Continuous optimization of stimulation settings is essential to maximizing therapeutic benefits.
To cite this abstract in AMA style:
K. Kimura, H. Kishida, K. Abe, N. Ueda, F. Tanaka. Optimization of Adaptive Deep Brain Stimulation Settings in Patients with Parkinson’s Disease [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/optimization-of-adaptive-deep-brain-stimulation-settings-in-patients-with-parkinsons-disease/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/optimization-of-adaptive-deep-brain-stimulation-settings-in-patients-with-parkinsons-disease/