Objective: To evaluate the feasibility and short-term outcomes of hybrid deep brain stimulation (DBS) conversion using the S8 adaptor in Parkinson’s disease (PD).

Background: DBS is an established treatment for PD when medical therapy is insufficient. As device technology has advanced, new options are increasingly needed in patients with older DBS systems. The S8 adaptor system allows existing DBS leads and extensions from one manufacturer to be connected to an implantable pulse generator from another manufacturer, enabling the use of multiple independent current control (MICC) programming and rechargeable pulse generator.

Method: We retrospectively reviewed patients with PD who underwent hybrid DBS conversion using the S8 adaptor for battery depletion in 2025–2026 at Asan Medical Center in Seoul. Conversion to a rechargeable pulse generator was performed without replacement or reinsertion of intracranial leads. Postoperative complications, stimulation setting adjustments, levodopa equivalent daily dose (LEDD), and Patient Global Impression of Improvement (PGI-I) were reviewed during follow-up.

Results: Four patients underwent pulse generator replacement using the S8 adaptor. Mean age was 69.5 years. Mean duration from diagnosis to initial DBS implantation was 15.5 years, and mean duration from initial DBS implantation to adaptor conversion was 4.25 years. One patient had bilateral subthalamic nucleus DBS and 3 had bilateral globus pallidus internus DBS. Conversion was technically successful in all 4 patients without lead revision or reinsertion, and no adaptor-related complication was observed during 1–2 months of follow-up. Postoperative stimulation setting changes were minimal, with voltage adjusted within 0.1 V. LEDD remained unchanged in all patients. At follow-up, the patient with bilateral subthalamic nucleus DBS was considered minimally improved (PGI-I=3), while the others showed no clear change (PGI-I=4). Adaptation to the rechargeable system was uneventful without reported discomfort.

Conclusion: Hybrid DBS conversion using the S8 adaptor was technically feasible in selected patients with PD, with no adaptor-related complication during short-term follow-up. Clinical status was generally maintained after conversion, and larger studies with longer follow-up are needed.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/hybrid-deep-brain-stimulation-conversion-using-the-s8-adaptor-in-parkinsons-disease/