Objective: To evaluate initial experiences and (symptom-specific) outcomes with adaptive deep brain stimulation (aDBS) for Parkinson’s disease (PD) in routine clinical care across multiple international centers.

Background: aDBS is an emerging neuromodulation strategy that dynamically adjusts delivery of stimulation based on local field potentials. While controlled experimental studies were promising, evidence on the feasibility of implementation of aDBS on a global scale and its initial clinical results remains scarce.

Method: We conducted a multicenter, retrospective, cohort study across international DBS centers that have implemented aDBS outside a research context. For each center, aggregated data on patient characteristics, indications for aDBS, implementation strategies, follow-up, clinical outcomes, and safety parameters were collected. The outcome of aDBS was assessed by: 1) overall clinical improvement, measured by the clinician-rated Clinical Global Impression of Improvement (CGI-I) score, and 2) improvement in specific motor signs, measured by the CGI-I score. A CGI-I score ≤ 3 indicated improvement. Aggregated results were presented using weighted medians.

Results: A total of 145 patients with PD treated with aDBS (median conventional DBS duration: 1 year; range 0-14.4 years; median disease duration: 10.9 years; 3-42 years) across 13 international centers were analyzed between November 2025 and February 2026. The median clinician-rated CGI-I score was 3, indicating subtle clinical improvement. Symptom-specific improvement was reported for tremor (10/11), dyskinesia (23/27), dystonia (8/11), gait-related problems (20/29), bradykinesia/rigidity (17/31), and dysarthria (10/23).

Conclusion: This international evaluation of aDBS for PD suggests that aDBS is feasible across multiple centres worldwide, including settings with varying levels of experience and personnel. Clinician-reported improvement at both an overall and symptom-specific level point to the potential of aDBS to align stimulation with individual patient needs. These findings highlight the need for prospective, patient-level studies to define which patients and symptom profiles benefit most from which aDBS parameters, and whether symptom-specific gains translate into long-term clinical improvement.

« Back to 2026 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/experiences-with-adaptive-deep-brain-stimulation-for-parkinsons-disease-in-routine-clinical-care/