Summary: The FDA has approved adaptive brain stimulation (ADB), a breakthrough therapy that regulates Parkinson’s disease symptoms in real time. Unlike traditional DBS, which provides constant stimulation, ADB monitors brain activity and responds with accurate electrical pulses to prevent stiffness and involuntary movement.
Two approved algorithms target the subthalamic nucleus, one that responds instantly to symptoms and the other that maintains stable brain activity. As this technology progresses, researchers are predicting more personalized treatments, including AI-driven DBS for non-motor symptoms such as depression and sleep dysfunction.
Important facts
Real-time symptom control: Adaptive DBS continuously monitors brain activity and provides accurate stimulation only when needed. Patients can switch between two FDA-approved algorithms to optimally manage symptoms.
Source: UCSF
From today, people with Parkinson’s disease have new treatment options thanks to Food and Drug Administration approval for groundbreaking new technology.
Therapy, known as adaptive deep brain stimulation, or ADB, uses an implanted device that continuously monitors the brain for signs of Parkinson’s symptoms. When detecting a specific pattern of brain activity, it provides electrical pulses that are precisely tuned to keep symptoms at bay.
The FDA approval covers two treatment algorithms that are run on devices created by medical device company Medtronic. Both work by monitoring the same part of the brain called the sub-vision nucleus. But they respond in a variety of ways.
The “fast” algorithm detects patterns related to symptoms and suppresses them immediately. The “slow” algorithm provides stimuli that maintains human brain activity within the range of symptoms alleviated.
The fast approach was developed in 2013 by neurologist Simon Little, Dr. MBBS, UC San Francisco, but was Peter Brown at Oxford University and Welcome Trust Clinical Research Fellow at MBBS.
ADBS has made significant advances in treatments called serial DBS or CDB, bringing constant stimulation to the brain. CDB has been used to improve the symptoms of Parkinson’s disease since it was approved by the FDA in 1999.
Unlike CDB, ADB can be sensed and adjusted as a patient’s brain activity changes. This often occurs when people with Parkinson’s disease are taking medication. Continuous monitoring of ADBS can also smooth out peaks and valleys of brain activity and dodge symptoms such as stiffness and involuntary movements.
Using software that communicates with the device via Bluetooth, patients and their healthcare providers can choose which adaptive algorithms to use and easily switch from one to the other.
With the more widely used algorithms, clinicians will gain more insight into how different patients experience them. They may be able to prescribe either one based on the patient’s knowledge.
“The early adaptive DBS algorithms approved today are just the first step in what is possible,” Little said.
Immediately, 24 hours a day care for Parkinson’s disease
Since coming to UCSF in 2019, people with Parkinson’s experience have not continued to develop and test new ADBS algorithms to treat non-motor symptoms such as mood dysfunction and insomnia, as well as motor symptoms such as stiffness and tremors.
In a study published last August, Little and neurosurgeon Philip Starr, MD, and PhD designed an algorithm to monitor and respond to brain signals in the cerebral cortex. This is a brain region that is different from the targets of the two algorithms approved by the FDA. The new algorithm and location improve symptoms and reduce side effects over CDB.
The UCSF initiative was ADB’s first “double-blind” trial. In other words, participants lived at home while the algorithm was changing, but neither they nor the researchers knew what the settings were in place at a particular time.
The UCSF team’s algorithm is more complicated than the team approved by the FDA on Monday. Researchers are still developing an approach, but the quality of life for participants in small clinical trials has improved, allowing former professional skateboarders to even return to his sport.
In the future, we rarely expect artificial intelligence to be able to easily customize algorithms. Future techniques will also address other Parkinson’s symptoms, such as depression and sleep dysfunction.
“We could give people with Parkinson’s disease a 24-hour personalized DBS therapy,” he said.
Researchers at UCSF are looking for ways to use personalized DBs for depression, chronic pain and obsessive-compulsive disorders. Today’s approval gives momentum to the development of DBS to treat these conditions.
About this DBS and Parkinson’s Disease Research News
Author: Robin Marks
Source: UCSF
Contact: Robin Marks – UCSF
Image: Image credited to Neuroscience News
