Sep 5, 2025

Chronic adaptive deep brain stimulation for Parkinson’s disease: clinical outcomes and programming strategies

Busch JL, Kaplan J, Behnke JK, Witzig VS, Drescher L, Habets JGV, Kühn AA.

*equal contribution

NPJ Parkinsons Dis. 2025; 11(1): 264.
doi: 10.1038/s41531-025-01124-7. PMID: 40883328.
Download summary: ReTune PoM 2025-08 Aug

Adaptive deep brain stimulation (DBS) dynamically adjusts stimulation amplitude based on neurophysiological feedback and may alleviate residual motor fluctuations in patients with Parkinson’s disease. However, potential clinical benefits and programming strategies remain poorly understood. We programmed eight patients with Parkinson’s disease on commercially available Dual Threshold adaptive DBS based on subthalamic beta power. Symptom severity was evaluated at home using ecological momentary assessments during two weeks of both continuous and adaptive DBS. Patients were not blinded to the stimulation mode. On the group level, overall well-being significantly improved with adaptive DBS (p = 0.007), and there was a non-significant trend toward enhanced general movement (p = 0.058). Within-subject analysis showed a significant improvement in overall well-being and general movement in three of eight patients. Six of eight patients chose to remain on adaptive DBS. Programming challenges included biomarker selection, threshold definition, and artifact-related maladaptation, for which targeted strategies are reported. Our findings support adaptive DBS as a potential option for selected Parkinson’s disease patients with persistent motor symptoms on continuous DBS. We propose a three-step programming approach to guide clinical implementation of adaptive DBS.

Dr. Johannes Busch

Johannes Busch is a medical doctor in the Kühn lab. His main research interest is invasive human neurophysiology in movement disorders and adaptive deep brain stimulation.

Jonathan Kaplan

Jonathan Kaplan is a medical doctor in the Kühn lab. He studies local field potentials (LFPs) and neurophysiological biomarkers to guide deep brain stimulation (DBS), with a focus on adaptive/closed-loop approaches in patients with movement disorders.

Prof. Andrea Kühn

Andrea Kühn is the director of the Movement Disorders and Neuromodulation Unit at Charité Berlin and the ReTune Spokesperson. Her research on basal ganglia electrophysiology has majorly contributed to the understanding of the pathophysiology of movement disorders and the mechanisms of action of DBS.