Cognitive Effects of Adaptive Deep Brain Stimulation in Parkinson’s Disease: Stability Without Risk

Background Adaptive deep brain stimulation (aDBS) is a closed-loop system that adjusts stimulation based on patient biomarkers. This study evaluated the cognitive safety of aDBS in Parkinson’s disease (PD). Methods Seventeen PD patients with bilateral subthalamic DBS underwent cognitive assessments (attention, language, memory) six days post-surgery during an 8-hour protocol. Testing occurred at five time points: T1 (aDBS, medication off), T2/T4 (aDBS, medication on), and T3/T5 (aDBS on, medication off). Four patients followed the same protocol with conventional DBS (cDBS). Results Results showed no cognitive fluctuations in aDBS patients (p ≥ 0.110). However, cDBS patients exhibited significant reaction time (RT) variations (p = .019), with RTs lower at T1 than T3 (p = .011) and T5 (p = .021), and at T4 compared to T2 (p = .002). Conclusion These findings suggest that 8-hour aDBS does not impact cognitive performance, providing preliminary evidence of its cognitive safety and stability in PD