Table 3 Parkinson’s disease studies with adaptive STN DBS

Little et al.¹⁶³

UK

N = 8,

Unilateral STN

Immediate postop,

externalized leads & customized neurostimulators

aDBS, cDBS, OFF DBS, & intermittent DBS in random order,

UPDRS items 20,22,23

13–35 Hz,

Single threshold

Blinded motor scores revealed ~30% improvement for aDBS vs. cDBS

5 min

aDBS ON time 50% less

Rosa et al.¹⁶⁴

Italy

N = 1,

Unilateral STN

Freely moving

Immediate post op,

externalized leads & customized neurostimulators

aDBS vs. cDBS,

UPDRS motor,

Rush Dyskinesia Rating Scale

13–17 Hz,

Single threshold

Bradykinesia & dyskinesia are both better with aDBS

2 h

Not Reported

Little et al.¹⁶¹

UK

N = 10,

Bilateral STN

Immediate post op,

externalized leads & customized neurostimulators

Blinded aDBS, cDBS, OFF DBS,

UPDRS motor scores

13–35 Hz,

Single threshold

aDBS improved speech intelligibility over cDBS, but not over no DBS

15 min

aDBS on time 40% less

Little et al.¹⁶⁵

UK

N = 4,

Bilateral STN

Immediate post op,

externalized leads & customized neurostimulators

aDBS vs. OFF DBS in random order, UPDRS motor

3–37 Hz,

Single threshold

aDBS > 40% improvement, axial & appendicular symptoms

15 min

aDBS on time 40% lower

Piña-Fuentes et al.¹⁶⁶

Netherlands

N = 1,

Bilateral STN

14 years after DBS during battery replacement,

externalized leads & customized neurostimulators

aDBS vs. cDBS vs. OFF DBS

13–30 Hz,

Single threshold

Quantitative bradykinesia improved with aDBS

12 min

Not Reported

Rosa et al.¹⁶²

Italy

N = 10,

Unilateral STN

Freely moving

Immediate post op,

externalized leads & customized neurostimulators

OFF DBS vs. aDBS vs. cDBS,

UPDRS motor

UDysRS

13–30 Hz,

Single threshold

aDBS less dyskinesia

2 h

aDBS > 70% lower

Arlotti et al.¹⁶⁸

Italy

N = 11

Unilateral STN

Freely moving

Immediate post op,

externalized leads & customized neurostimulators

aDBS vs. OFF DBS

UPDRS, UDysRS

Off meds & on meds

11–30 Hz,

Single threshold

aDBS 30% motor improvement even off meds; less dyskinesia

8 h

Not Reported

Arlotti et al.¹⁶⁷

Germany

N = 1,

Bilateral STN

Freely moving

4 years after DBS when battery replacement,

externalized leads connected to AlphaDBS device

aDBS, mUPDRS

11–30 Hz,

Single threshold

aDBS improved UPDRS-III score > 35% throughout

24 h, including overnight sleep

Not Reported

Velisar et al.¹⁷⁰

USA

N = 13

Uni- or Bilateral STN

fully implanted neurostimulator

Medtronic Activa PC + S

aDBS, cDBS, & OFF DBS,

bradykinesia (repetitive wrist flexion-extension task),

tremor (motion sensor)

13–30 Hz,

dual threshold

Tremor & bradykinesia improved

20 min

aDBS 44% lower

Petrucci et al.¹⁷¹

USA

N = 1,

Bilateral STN

fully implanted neurostimulator

Medtronic Summit

RC + S

aDBS, cDBS, & off DBS

13–35 Hz,

Dual threshold

Freezing & step rhythmicity better with aDBS

~30 sec

No Difference

Piña-Fuentes et al.¹⁷²

Netherlands

N = 13,

Bilateral STN

~7 years after DBS when battery replacement,

externalized leads & customized neurostimulator

aDBS, cDBS, & no DBS in random order

13–35 Hz, single threshold

UPDRS and tremor subscores lower in cDBS and aDBS conditions; speech intelligibility better

~ 2-5 min

aDBS used 51% of time

Bocci et al.¹⁷³

Italy

N = 8,

Bilateral STN

Immediate postop,

externalized leads connected to AlphaDBS device

cDBS first day, aDBS next day,

UPDRS motor, Rush dyskinesia scale

13–30 Hz dual threshold

aDBS improved rigidity, with less dyskinesia

8 h

aDBS 42% lower

Gilron et al.¹⁷⁴

USA

N = 5,

Bilateral STN

Bilateral motor cortex subdural paddle electrodes

Immediate postop to several months, Full implanted Medtronic Summit RC + S

2 subjects recorded with aDBS,

3 subjects with cDBS

Cortical gamma was recorded

13–30 Hz, Single threshold

ON time with dyskinesia reduced with aDBS over cDBS

> 2600 h

Not Reported

He et al.¹⁷⁵

UK

N = 13,

Bilateral STN

externalized leads & customized neurostimulators

aDBS,cDBS, no DBS

13–30 Hz

Single threshold

aDBS similar to cDBS in reaching tasks, worse in tremor

~ 90 sec

No difference

Oehrn et al.¹⁵⁸

USA

N = 4,

Bilateral STN

Bilateral subdural sensorimotor paddle electrodes

1+ year after DBS,

fully implanted neurostimulator

Medtronic Summit

RC + S

aDBS & cDBS

randomized cross-over pilot trial

Cortical gamma was recorded

13–30 Hz

Single threshold

Less bradykinesia, less dyskinesia, better QOL

One month

aDBS 20% higher

Busch et al.¹⁷⁶

Germany

N = 12,

10 Unilateral,

2 Bilateral STN

Immediate postop,

externalized leads connected to AlphaDBS device

aDBS with varying onset times for movement tasks & smoothing times for beta power, MDS-UPDRS III

13–30 Hz,

Single threshold

Beta power suppression impacted by onset time for movement tasks

190 sec

Not Reported