Directional Adaptive Deep Brain Stimulation: An Initial Report of Safety, Tolerability, and Effectiveness
BACKGROUND: Adaptive deep brain stimulation (aDBS) is a safe and effective therapy for people with Parkinson's disease (PWP). Utilization of directional aDBS has not been specifically evaluated. OBJECTIVES: The goal is to report the first data on the safety, tolerability, and preliminary effectiveness of chronic, directional aDBS in PWP. METHODS: A supplemental cohort from the Adaptive DBS Algorithm for Personalized Therapy in Parkinson's Disease Trial received directional aDBS. Participants who were previously receiving stable continuous directional DBS (dDBS) completed an open-label evaluation of two aDBS modes. RESULTS: Seventeen participants were enrolled, with 15 completing directional aDBS evaluation. The prespecified primary endpoint and post hoc success criterion was met for both directional aDBS modes. On-time without troublesome dyskinesia was increased, with a median of 1.2 hours/day in directional dual threshold aDBS mode. Stimulation-related events were similar between dDBS and directional aDBS. All 15 participants chose to continue with directional aDBS chronically. CONCLUSIONS: Preliminary data indicates chronic directional aDBS is feasible, tolerable, effective, and safe in PWP. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Authors
- Kyle T. Mitchell (ORCID: https://orcid.org/0000-0003-4788-1581)
- Martijn Beudel (ORCID: https://orcid.org/0000-0002-2488-7051)
- Talya Goble
- Jill L. Ostrem (ORCID: https://orcid.org/0000-0001-7018-9521)
- Adolfo Ramirez–Zamora (ORCID: https://orcid.org/0000-0001-9253-3899)
- Michał Gostkowski (ORCID: https://orcid.org/0000-0003-3606-1182)
- Robert S. Raike
- Todd M. Herrington (ORCID: https://orcid.org/0000-0001-9489-7418)
- Scott R. Stanslaski (ORCID: https://orcid.org/0000-0002-3513-2391)
- Elena Moro (ORCID: https://orcid.org/0000-0002-7968-5908)
- Alfonso A. Fasano (ORCID: https://orcid.org/0000-0001-5346-0180)
- Rebekah L. S. Summers (ORCID: https://orcid.org/0000-0002-1783-3362)
- Leonardo Almeida (ORCID: https://orcid.org/0000-0002-0921-887X)
- Simon J Little (ORCID: https://orcid.org/0000-0001-6249-6230)
- Travis Hassell
- Lisa Tonder
- Helen M Bronte-Stewart (ORCID: https://orcid.org/0000-0002-1839-4541)
- Ye Tan
- the ADAPT‐PD Trial Investigators
Institutions
- University of Minnesota (US)
- Cleveland Clinic (US)
- Humanitas University (IT)
- Harvard University (US)
- University of Louisville (US)
- Duke University (US)
- Toronto Western Hospital (CA)
- Cleveland Foundation (US)
- Centre Hospitalier Universitaire de Grenoble (FR)
- Massachusetts General Hospital (US)
- Medtronic (United States) (US)
- Grenoble Institute of Neurosciences (FR)
- Amsterdam University Medical Centers (NL)
- Duke University Hospital (US)
- Ontario Brain Institute (CA)
- International Neuromodulation Society (US)
- IRCCS Humanitas Research Hospital (IT)
- Université Grenoble Alpes (FR)
- Vanderbilt University Medical Center (US)
- Stanford University (US)
Publication Details
- Journal
- Movement Disorders
- Published
- 2026-10-05
- DOI
- https://doi.org/10.1002/mds.70556
- Primary Topic
- Neurological disorders and treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00