22 Sept 2025

Adaptive deep brain stimulation for Parkinson's tested over months in a small open-label trial

Neurotechnology and human augmentationMedical technology and bioelectronics
AI illustration · Illustrative scene, not a photograph of the specific device or experiment.

What was demonstrated

In the ADAPT-PD trial, 68 people with Parkinson's disease who already used conventional deep brain stimulation (cDBS) were enrolled. Of these, 40 were evaluated on dual-threshold adaptive DBS (DT-aDBS) and 35 on single-threshold adaptive DBS (ST-aDBS). The primary outcome was on-time without troublesome dyskinesia. Under the prespecified threshold, 95% (DT-aDBS) and 87% (ST-aDBS) of evaluated participants met the goal. The threshold was revised after the planned analysis to a post hoc limit of no more than 2 hours a day of lost on-time without troublesome dyskinesia. Under that revised threshold, 91% (DT-aDBS) and 79% (ST-aDBS) met it. Total electrical energy delivered (TEED), a secondary outcome, was about 13% lower with DT-aDBS (borderline, P = .05) and about 15% lower with ST-aDBS (P = .01) than with cDBS. Mean aDBS exposure was 17.5 months (range 3 to 27). The authors report no unanticipated serious adverse device events.

Why it matters

Adaptive stimulation changes how much electrical stimulation is delivered. In this trial, the energy delivered was lower than with conventional DBS, and most evaluated participants met the revised on-time threshold. The trial did not test a direct symptom comparison with conventional DBS as a primary aim. Exploratory, unblinded comparisons favoured adaptive DBS on the MDS-UPDRS III motor score (2.6 points lower on DT-aDBS than cDBS), while a quality-of-life measure (PDQ-39) did not differ. Larger controlled studies are needed before anyone can say whether adaptive DBS works better than conventional DBS.

Caveats

  • The abstract describes the trial as open-label. Participants and investigators were not blinded to adaptive versus conventional DBS, and the authors say placebo effects may inflate the results.
  • The on-time threshold was revised after the planned analysis to reduce type I error risk. The authors say confirmatory inference is precluded, so the P values are nominal.
  • The sample was small (68 enrolled, 40 and 35 evaluated). The authors say it is too small to identify predictors of outcome or to compare subgroups.
  • Medtronic sponsored and funded the trial and was involved in its design, conduct and analysis. Several authors are Medtronic employees.

Technology profiles

Sources

  1. peer reviewed paper
    Long-Term Personalized Adaptive Deep Brain Stimulation in Parkinson Disease: A Nonrandomized Clinical Trial
    Helen M. Bronte-Stewart, Martijn Beudel, Jill L. Ostrem et al.. JAMA Neurology, 22 Sept 2025. DOI: 10.1001/jamaneurol.2025.2781.

Last reviewed 21 Oct 2026.