Deep brain stimulation (DBS) is a successful treatment for patients with Parkinson's disease. In adaptive DBS, stimulation is titrated according to feedback about clinical state and underlying pathophysiology. This contrasts with conventional stimulation, which is fixed and continuous. In acute trials, adaptive stimulation matches the efficacy of conventional stimulation while delivering about half the electrical energy. The latter means potentially fewer side‐effects. The next step is to determine the long‐term efficacy, efficiency, and side‐effect profile of adaptive stimulation, and chronic trials are currently being considered by the medical devices industry. However, there are several different approaches to adaptive DBS, and several possible limitations have been highlighted. Here we review the findings to date to ascertain how and who to stimulate in chronic trials designed to establish the long‐term utility of adaptive DBS. © 2020 International Parkinson and Movement Disorder Society

中文翻译：

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调试帕金森病的自适应深部脑刺激

深部脑刺激 (DBS) 是治疗帕金森病患者的成功方法。在适应性 DBS 中，根据有关临床状态和潜在病理生理学的反馈来滴定刺激。这与固定且连续的传统刺激形成对比。在急性试验中，适应性刺激与传统刺激的功效相匹配，同时提供大约一半的电能。后者意味着潜在的副作用更少。下一步是确定适应性刺激的长期疗效、效率和副作用，目前医疗器械行业正在考虑进行长期试验。然而，自适应 DBS 有几种不同的方法，并且已经强调了几个可能的局限性。在这里，我们回顾了迄今为止的研究结果，以确定在旨在建立适应性 DBS 长期效用的长期试验中，如何刺激以及刺激谁。© 2020 国际帕金森和运动障碍协会