Background Beta-based adaptive Deep Brain Stimulation (aDBS) is effective in Parkinson’s disease (PD), when assessed in the immediate post-implantation phase. However, the potential benefits of aDBS in patients with electrodes chronically implanted, in whom changes due to the microlesion effect have disappeared, are yet to be assessed. Methods To determine the acute effectiveness and side-effect profile of aDBS in PD compared to conventional continuous DBS (cDBS) and no stimulation (NoStim), years after DBS implantation, 13 PD patients undergoing battery replacement were pseudo-randomised in a crossover fashion, into three conditions (NoStim, aDBS or cDBS), with a 2-min interval between them. Patient videos were blindly evaluated using a short version of the Unified Parkinson’s Disease Rating Scale (subUPDRS), and the Speech Intelligibility Test (SIT). Results Mean disease duration was 16 years, and the mean time since DBS-implantation was 6.9 years. subUPDRS scores (11 patients tested) were significantly lower both in aDBS (p = <.001), and cDBS (p = .001), when compared to NoStim. Bradykinesia subscores were significantly lower in aDBS (p = .002), and did not achieve significance during cDBS (p = .08), when compared to NoStim. Two patients demonstrated re-emerging tremor during aDBS. SIT scores of patients who presented stimulation-induced dysarthria significantly worsened in cDBS (p = .009), but not in aDBS (p = .407), when compared to NoStim. Overall, stimulation was applied 48.8% of the time during aDBS. Conclusion Beta-based aDBS is effective in PD patients with bradykinetic phenotypes, delivers less stimulation than cDBS, and potentially has a more favourable speech side-effect profile. Patients with prominent tremor may require a modified adaptive strategy.

中文翻译：

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自适应脑深部刺激对帕金森病的急性影响

背景 基于 Beta 的自适应脑深部刺激 (aDBS) 在植入后立即评估时对帕金森病 (PD) 有效。然而，aDBS 对长期植入电极的患者的潜在益处尚待评估，在这些患者中，由于微损伤效应引起的变化已经消失。方法 为了确定 aDBS 与传统连续 DBS (cDBS) 和无刺激 (NoStim) 相比在 PD 中的急性疗效和副作用，DBS 植入后数年，13 名接受电池更换的 PD 患者以交叉方式进行伪随机分组，分为三个条件（NoStim、aDBS 或 cDBS），它们之间有 2 分钟的间隔。使用统一帕金森病评定量表 (subUPDRS) 的简短版本对患者视频进行盲目评估，和语音清晰度测试 (SIT)。结果平均病程16年，DBS植入后平均6.9年。与 NoStim 相比，aDBS (p = <.001) 和 cDBS (p = .001) 的 subUPDRS 评分（测试的 11 名患者）均显着降低。与 NoStim 相比，aDBS 的运动迟缓子评分显着降低 (p = .002)，并且在 cDBS 期间没有达到显着性 (p = .08)。两名患者在 aDBS 期间表现出再次出现震颤。与 NoStim 相比，在 cDBS 中出现刺激诱发的构音障碍的患者的 SIT 评分显着恶化（p = .009），但在 aDBS 中则没有（p = .407）。总体而言，在 aDBS 期间，有 48.8% 的时间应用了刺激。结论 基于 Beta 的 aDBS 对具有运动迟缓表型的 PD 患者有效，提供的刺激少于 cDBS，并且可能具有更有利的语音副作用特征。有明显震颤的患者可能需要改进的适应性策略。