Category: Surgical Therapy: Parkinson's Disease
Objective: The aims of the study were to (I) gather the opinion of clinical and academic DBS experts on adaptive deep brain stimulation (aDBS), and (II) discuss it in the light of the current clinical and scientific knowledge.
Background: Conventional DBS (cDBS) delivers continuous electrical stimuli regardless the actual functional state of the patient, therefore causing treatment-induced adverse effects such as speech impairments and increased risk of falls. Adaptive DBS (aDBS) is a novel technology which promises to overcome such limitation, allowing for a contingency-based and symptoms-related stimulation. However, CL-DBS field is still at its infancy, and experts’ opinions could provide useful insight to guide future research and clinical practice.
Method: In this work, we identified clinical and academic DBS positional leaders to discuss the challenges related to aDBS research and clinical applications, replying a 5-points Likert scale questionnaire according to Delphi method process. A Steering Committee (SC) of experts (n=8) based on the collaborative network of the leading authors discussed the topic and developed a structured questionnaire including key items pertinent to aDBS using five-point Likert scales (1=strongly disagree; 2=disagree; 3=undecided; 4=agree; 5=strongly agree) [25]. In rounds one, two and three, quantitative assessments to reach a consensus were performed by SC members and a larger Expert Panel (EP) (total experts=21).
Results: Experts agreed that CL-DBS is as a safe and promising methodology, that could soon overcome the current technological limitations and become a clinical reality also for patients with Parkinson’s disease who experience motor fluctuations and dyskinesias during cDBS or are tremor-dominant.
Conclusion: Currently, although the results are promising, there is limited clinical evidence on aDBS applications. Clinical and academic DBS positional leaders agreed that, despite the current technological limitations, aDBS will be of clinically routine for movement disorders patients.
To cite this abstract in AMA style:
M. Guidetti, T. Bocci, M. de Pedro, G. Deuschl, A. Fasano, R. Martinez Fernandez, C. Gasca-Salas, C. Hamani, J. Krauss, A. Kühn, P. Limousin, S. Little, A. Lozano, N. Maiorana, M. Okun, S. Oliveri, J. Ostrem, E. Scelzo, A. Schnitzler, P. Starr, Y. Temel, L. Timmermann, G. Tinkhauser, V. Visser-Vandewalle, J. Volkmann, A. Priori. The Challenges of Adaptive Deep Brain Stimulation: A Delphi Panel Study [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/the-challenges-of-adaptive-deep-brain-stimulation-a-delphi-panel-study/. Accessed June 14, 2025.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/the-challenges-of-adaptive-deep-brain-stimulation-a-delphi-panel-study/