Progress towards a form of adaptable deep brain stimulation

Researchers at the University of California San Francisco explored whether adaptive deep brain stimulation (DBS) could improve movement symptoms for 4 people living with Parkinson’s when compared to standard DBS. Results show that adaptive DBS can respond to falling dopamine levels in the brain to better control symptoms around the clock.

Current DBS provides electrical stimulation to brain areas to help control movement symptoms in Parkinson’s. The stimulation can be turned on or off but its amount doesn’t vary. This more adaptable form of DBS was shown to respond to the movement needs of the participants. It altered stimulation levels to better control symptoms when medication was wearing off, increasing stimulation if the person was particularly active or decreasing stimulation while the person was asleep.

All 4 people reported that their most troubling symptoms were improved by the adaptive DBS, and more consistently than with the standard DBS. They also shared that the adaptive DBS reduced side effects of too much or too little stimulation, and improved their quality of life.

What is Deep Brain Stimulation?

Parkinson’s is a progressive condition, meaning that symptoms of Parkinson’s get worse over time. Some people choose to explore DBS to help control some symptoms of Parkinson’s, when medications become less effective.

DBS involves surgery, where a pulse generator (a device like a heart pacemaker) is placed under the skin around the chest or stomach area. It’s connected to 1 or 2 fine wires that are inserted into specific areas of the brain. When the pulse generator is switched on, the electrodes deliver constant, high-frequency stimulation to the targeted area. This stimulation changes some of the electrical signals in the brain that cause the symptoms of Parkinson’s.

What did the researchers do?

The study involved monitoring the symptoms of 4 men who received both standard, and then adaptive DBS therapy. The team monitored changes in dopamine levels in each participant’s brain over time, and then used artificial intelligence (AI) to develop an idea of what stimulation they might need at different times.

Read the abstract of the scientific paper in the journal of Nature Medicine.

Claire Bale, Associate Director of Research at Parkinson’s UK, said:

"Current DBS can be life changing and has the promise to be even more effective if it could be responsive to the needs of the individual. This research represents a major step towards this.

"While this study was well controlled, it was small. The promising results support the need for larger clinical trials to confirm the therapy’s safety and effectiveness and provide the evidence required for adaptive DBS before it could become a much needed new treatment for people with Parkinson’s."