Abstract
The future of deep brain stimulation (DBS) for Parkinson's disease (PD) lies in new closed‐loop systems that continuously supply the implanted stimulator with new settings obtained by analyzing a feedback signal related to the patient's current clinical condition.1 The most suitable feedback for PD is subthalamic local field potential (LFP) activity recorded from the stimulating electrode itself.2, 3, 4 This closed‐loop technology known as adaptive DBS (aDBS) recently proved superior to conventional open‐loop DBS (cDBS) in patients with PD.2
Highlights
The future of deep brain stimulation (DBS) for Parkinson’s disease (PD) lies in new closed-loop systems that continuously supply the implanted stimulator with new settings obtained by analyzing a feedback signal related to the patient’s current clinical condition.[1]
Uisite for developing new implantable adaptive DBS (aDBS) devices for chronic PD treatment. In this single-case study, we tested whether a portable DBS device we developed is suitable to compare the clinical benefit in a freely moving PD patient induced by either aDBS or conventional open-loop DBS (cDBS)
Because we evaluated the patient a few days after surgery when he probably manifested a stunning effect,[5] the aDBSand cDBS-induced improvements were lower than those reported by others in follow-up DBS studies.[6]
Summary
The future of deep brain stimulation (DBS) for Parkinson’s disease (PD) lies in new closed-loop systems that continuously supply the implanted stimulator with new settings obtained by analyzing a feedback signal related to the patient’s current clinical condition.[1]. LETTERS: NEW OBSERVATIONS uisite for developing new implantable aDBS devices for chronic PD treatment In this single-case study, we tested whether a portable DBS device we developed is suitable to compare the clinical benefit in a freely moving PD patient induced by either aDBS or cDBS. Because we evaluated the patient a few days after surgery when he probably manifested a stunning effect,[5] the aDBSand cDBS-induced improvements were lower than those reported by others in follow-up DBS studies.[6] A major clinical achievement was that compared with cDBS, aDBS greatly reduced the patient’s dyskinesias during gait and at rest (Fig. 1B; Fig. 1D) It did so because we designed the adaptive algorithm to avoid dyskinesias related to hyperstimulation: when L-dopa reduced beta-band LFP activity, the voltage linearly diminished, avoiding hyperstimulation. We await future studies to confirm our findings and to test other aDBS LFP-based algorithms, our observation is a step toward developing a new generation of implantable aDBS devices for chronic treatment of PD
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