Long-Term Effectiveness of At-Home Adaptive Deep Brain Stimulation in Parkinson's Disease

Recent research conducted by the Department of Neurology and Neurological Sciences at Stanford University School of Medicine, in collaboration with multiple academic medical centers and industry partner Medtronic, has demonstrated that long-term at-home adaptive deep brain stimulation (aDBS) is a safe, tolerable, and effective treatment option for individuals with Parkinson's disease who are already stable on continuous stimulation therapy. The study, titled "Long-Term Personalized Adaptive Deep Brain Stimulation in Parkinson Disease: A Nonrandomized Clinical Trial," published in JAMA Neurology, aimed to compare the efficacy and safety of adaptive stimulation with traditional continuous stimulation.

The trial involved 68 participants with moderate to advanced Parkinson's disease, all of whom had bilateral leads implanted in the subthalamic nucleus or globus pallidus internus and met specific neural sensing criteria across centers in the US, Canada, and Europe. Participants underwent an open-label, crossover study where they tested two adaptive stimulation modes—single-threshold and dual-threshold algorithms—that adjusted stimulation based on local field potential power within the 8–30 Hz alpha-beta band.

Each participant experienced 30 days of at-home monitoring with stable medication levels. The primary goal was to determine the proportion of participants who maintained optimal on-time stimulation without troublesome dyskinesias, comparing it to standard continuous therapy. The post hoc analysis revised the threshold to a maximum of two hours per day of symptom off-time.

Results showed that under the modified threshold, 91% of participants using dual-threshold mode and 79% using single-threshold mode maintained comparable on-time stimulation as continuous DBS, with no significant differences between modes. Notably, energy consumption was reduced by about 15% in the single-threshold mode, indicating a potential benefit for device longevity. Safety assessments revealed minimal stimulation-related adverse events, all resolving during adjustments, and no serious device complications over the follow-up period.

The findings suggest that personalized, adaptive deep brain stimulation administered at home is a feasible and safe alternative to continuous stimulation, with the added advantage of reduced energy use and preserved clinical benefits. This advancement points toward more individualized and energy-efficient management of Parkinson's disease, improving patient quality of life.

Source: https://medicalxpress.com/news/2025-09-term-home-deep-brain-effective.html