Journal Article (Review Article)

DZNE-2026-00682

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Adaptive Deep Brain Stimulation for Parkinson's Disease: Navigating the Roadblocks to Clinical Implementation.

Koeglsperger, T. (First author)DZNE* ; Scherer, M. ; Kühn, A. A.DZNE* ; Eusebio, A. ; Fasano, A. ; Krauss, J. K.

2026
Wiley New York, NY

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Please use a persistent id in citations: doi:10.1002/mds.70284

Abstract: Adaptive deep brain stimulation (aDBS) represents an important evolution in the treatment of Parkinson's disease (PD), building on conventional DBS (cDBS) by adjusting stimulation in response to real-time physiological signals. By enabling dynamic targeting of disease-related neural activity, aDBS offers the potential for more precise modulation of motor symptoms. Additional anticipated advantages include reduced stimulation-related side effects and improved energy efficiency, supporting long-term device performance. Although clinical uptake is still at an early stage, growing experience has highlighted both opportunities and areas requiring further refinement. Key challenges include inter-individual variability in biomarker expression, diversity in programming approaches, and ongoing debate regarding optimal thresholds and response latencies. The clinical significance of short-term local field potential (LFP) recordings continues to be actively investigated, particularly in the context of signal artifacts, physiological variability, and current hardware limitations. Beyond technical considerations, factors such as patient selection, ethical frameworks, and cost-effectiveness remain important determinants of broader implementation. Continued progress will depend on the development of robust and flexible control strategies that incorporate multimodal biomarkers, including wearable-derived motor metrics and patient-reported outcomes, to support personalized therapy. With an expanding evidence base and recent regulatory approvals, aDBS is increasingly transitioning from an experimental concept to a viable clinical tool. Future efforts should prioritize the translation of research paradigms into scalable clinical workflows that effectively balance automation with individualized patient care. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Keyword(s): Humans (MeSH) ; Deep Brain Stimulation: methods (MeSH) ; Parkinson Disease: therapy (MeSH) ; Local Field Potential Measurement (MeSH) ; Parkinson's disease ; adaptive DBS ; biomarker ; control algorithm ; deep brain stimulation (DBS)

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Contributing Institute(s):

1. Clinical Research (Munich) (Clinical Research (Munich))
2. Movement Disorders (Parkinson's disease, Dystonia) (AG Kühn)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2026

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Database coverage:
; ; ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; DEAL Wiley ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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