Self-Adjusting Brain Pacemaker May Help Reduce Parkinson’s Disease Symptoms

A small feasibility study funded by the National Institutes of Health (NIH) found that an implanted device regulated by the body’s brain activity could provide continual and improved treatment for the symptoms of Parkinson’s disease (PD). 
 
This type of treatment is called adaptive deep brain stimulation (aDBS) and is an improvement on a technique that has been used for PD and other brain disorders for many years. The study found aDBS was markedly more effective at controlling PD symptoms compared to conventional DBS treatments.
 
DBS involves implanting electrodes into the brain at specific locations. These wires then deliver electrical signals that can help mitigate the symptoms of brain disorders such as PD. Conventional DBS provides a constant level of stimulation and can also lead to unwanted side effects because the brain does not always need the same strength of treatment. Therefore, aDBS uses data taken directly from a person’s brain and uses machine learning to adjust the level of stimulation in real-time as the person’s needs change over time.
 
“This study marks a big step forward towards developing a DBS system that adapts to what the individual patient needs at a given time. By helping to control residual symptoms while not exacerbating others, adaptive DBS has the potential to improve the quality of life for some people living with Parkinson’s disease,” said Megan Frankowski, Ph.D., program director for NIH’s Brain Research Through Advancing Innovative Neurotechnologies Initiative, or The BRAIN Initiative, which helped fund this project.
 
Four people already receiving conventional DBS were first asked what they felt was their most bothersome symptom that had persisted despite treatment. In many instances, this was either involuntary movements or difficulty in initiating movement. The participants were then set up to receive aDBS treatment alongside their existing DBS therapy. After training the aDBS algorithm for several months, the participants were sent home, where the comparison test was performed by alternating between conventional and aDBS treatments. Changes occurred every two to seven days.
 
aDBS improved each participant’s most bothersome symptom by roughly 50% compared to conventional DBS. Notably, even though they were not told which type of treatment they were receiving at any one time, three of the four participants were often able to correctly guess when they were on aDBS due to noticeable symptom improvement.
 
This project is a continuation of several years of work led by Philip Starr, M.D., Ph.D., and colleagues at the University of California, San Francisco. Previously, in 2018, they reported the development of an adaptive DBS system, referred to as a “closed loop” system, that adjusted based on feedback from the brain itself. Later, in 2021, they described their ability to record brain activity in people as they went about their daily lives.