One-year subthalamic recordings in a patient with Parkinson’s disease under adaptive deep brain stimulation

SUMMARY We present the clinical data and subthalamic recordings of a patient with Parkinson’s disease treated for one year with adaptive deep brain stimulation (aDBS). This novel stimulation mode, which adjusts the current amplitude linearly with respect to subthalamic beta power, produced a clinical benefit that was superior to the previous conventional stimulation that used constant, predefined parameters (cDBS). Compared with cDBS, the subthalamic beta amplitude was higher with aDBS and displayed larger daily fluctuations. Furthermore, subthalamic beta amplitude decreased during sleeping with respect to waking hours under aDBS. These data suggest a robust neuromodulatory mechanism of aDBS, with a clinical effect that was superior in this patient compared to cDBS. Our results open new perspectives for a restorative brain network effect of aDBS as a more physiologic, bidirectional, brain–computer interface.