UC San Francisco researchers have developed a new form of deep brain stimulation (DBS) that adjusts in real time as a person walks, improving gait and reducing falls in people with Parkinson's disease.
The Innovation: Adaptive Deep Brain Stimulation
Standard DBS delivers fixed stimulation regardless of activity, which limits its effect on gait—a behavior that is constantly changing. The new system, known as adaptive DBS (aDBS) , detects neural signals associated with each step and automatically adjusts stimulation within fractions of a second.
The system works by embedding personalized neural signatures into the implanted neurostimulator to respond to movement in real time.
The Science: How It Works
Senior author Dr. Doris D. Wang explains the core principle:
"Walking is a dynamic behavior requiring precise timing. This system works with the patient as they move."
First author Dr. Kenneth H. Louie adds:
"We identified neural signatures linked to each step to guide stimulation in real time."
Study Results
The study, published June 15 in Nature Medicine, enrolled five participants with Parkinson's disease who had previously undergone DBS surgery. The results were measured in two key settings:
- In the lab: The aDBS system improved gait symmetry and reduced walking variability.
- In a home setting: In a blinded crossover study, participants experienced fewer falls with aDBS. No serious adverse events were reported.
Funding and Disclosures
The research was supported by the Michael J. Fox Foundation, UCSF Burroughs Wellcome Fund, NINDS, and UCSF Catalyst Grants.
Disclosures: D.D.W. consults for Medtronic, Boston Scientific, and Iota Bioscience and receives research support from Boston Scientific. P.A.S. receives support from Medtronic and Boston Scientific. K.H.L. is a current employee of Echo Neurotechnologies, with the work completed prior to his employment. Echo Neurotechnologies had no role in the study.