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@ARTICLE{Busch:280917,
      author       = {Busch, Johannes L and Kaplan, Jonathan and Behnke, Jennifer
                      K and Witzig, Victoria S and Drescher, Luisa and Habets,
                      Jeroen G V and Kühn, Andrea A},
      title        = {{C}hronic adaptive deep brain stimulation for {P}arkinson's
                      disease: clinical outcomes and programming strategies.},
      journal      = {npj Parkinson's Disease},
      volume       = {11},
      number       = {1},
      issn         = {2373-8057},
      address      = {[London]},
      publisher    = {Springer Nature},
      reportid     = {DZNE-2025-01000},
      pages        = {264},
      year         = {2025},
      abstract     = {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.},
      cin          = {AG Kühn},
      ddc          = {610},
      cid          = {I:(DE-2719)5000008},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40883328},
      pmc          = {pmc:PMC12397205},
      doi          = {10.1038/s41531-025-01124-7},
      url          = {https://pub.dzne.de/record/280917},
}