UCI Health now offers adaptive deep brain stimulation (aDBS), a novel therapeutic approach for patients with Parkinson’s disease that represents a meaningful advancement in the treatment of motor symptoms. The U.S. Food and Drug Administration recently approved the first aDBS system, which dynamically adjusts stimulation parameters based on real-time neural feedback — marking a pivotal shift from fixed-output systems to responsive, individualized therapy.
Addressing a clinical gap
Conventional deep brain stimulation (DBS) delivers continuous electrical stimulation to targeted regions of the basal ganglia, most commonly the subthalamic nucleus (STN) or globus pallidus internus (GPi). While effective, standard DBS systems are limited by static programming that cannot account for fluctuations in brain activity throughout the day. This can result in suboptimal control of symptoms such as bradykinesia, tremor and rigidity, as well as stimulation-induced side effects such as dysarthria, gait dysfunction and dyskinesia.
Adaptive DBS systems overcome these limitations by integrating sensing and therapeutic functions within the same device. They continuously record local field potentials (LFPs) from the implanted electrodes, using biomarkers — such as beta-band oscillations — to guide the delivery of stimulation. In real time, the system increases or decreases stimulation according to physiologic need, allowing for personalized modulation of neural circuits.
Scientific underpinnings
Exaggerated beta activity in the STN has long been associated with motor impairment in Parkinson’s disease. aDBS targets this biomarker directly, enabling a closed-loop system in which stimulation is automatically titrated to suppress pathologic beta rhythms. In early clinical trials, this approach has been shown to reduce stimulation-induced side effects while maintaining or improving motor symptom control. Notably, patients experience fewer fluctuations and may require fewer reprogramming visits, resulting in both clinical and operational benefits.
UCI Health clinical expertise
At UCI Health, aDBS is available through the Parkinson’s Disease and Movement Disorders Program, a multidisciplinary subspecialty practice within the Department of Neurology. This program offers comprehensive care for patients with advanced Parkinson’s disease and other movement disorders, including dystonia and essential tremor.
Our neurologists are fellowship-trained in movement disorders and offer extensive experience in DBS patient selection, surgical planning, and postoperative programming. The team works in close collaboration with UCI Health neurosurgeons and neurophysiologists to ensure precision targeting and individualized device settings.
“The integration of sensing and stimulation is a significant leap forward,” said UC Irvine School of Medicine Department of Neurology Chair Claire Henchcliffe, MD, DPhil. “This platform enables us to tailor therapy in a way that aligns with the real-time needs of each patient’s brain — which we believe will have a major impact on long-term outcomes and quality of life.”
Referral guidance
Adaptive DBS is most appropriate for patients with Parkinson’s disease who experience motor fluctuations or dyskinesias despite optimized medical therapy, and who are candidates for conventional DBS. Selection criteria remain consistent, but referral for pre-surgical evaluation should ideally occur before significant cognitive decline or loss of functional independence.
The UCI Health team provides multidisciplinary evaluation, surgical candidacy review, and ongoing management in collaboration with referring neurologists and primary care providers. Clinicians interested in learning more or referring a patient can call 888-456-7002.
Looking ahead
The deployment of aDBS reflects UCI Health’s commitment to advancing personalized neuroscience. As the only academic health system based in Orange County, UCI Health is uniquely positioned to offer this technology in a multidisciplinary academic setting — pairing surgical expertise with clinical research, advanced imaging and long-term care coordination.
This innovation also opens the door to expanded indications in the future, including the treatment of dystonia, obsessive-compulsive disorder, and other neurologic and psychiatric conditions that may benefit from responsive neuromodulation.
For now, aDBS represents a meaningful step forward for patients with Parkinson’s disease — offering greater precision, fewer side effects and the potential for better outcomes in the daily management of motor symptoms.