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DBS and aDBS


What is DBS (Deep Brain Stimulation)?


DBS is a neurological treatment process through which the surgical implantation of electrodes in the brain serves to modulate electronic pulses in the brain between neurons1. The device aims to revert the brain to "normalized" functioning, between which an implanted pulse generator (IPG) sends electricity through a lead wire into a targeted area of the brain1, DBS has been related to acting almost like a pacemaker for the brain, creating a rhythmic pattern of electronic signals in the brain1.



OHSU Brain Institute, 2025
OHSU Brain Institute, 2025

Deep brain stimulation was first used by Dr. Robert G. Heath in the 1950s and 60s as a targeted schizophrenia treatment and sexual preference therapies1. His controversial and ethically fraught studies included intercranial electronic stimulation of various cortices through lead placements in participant's brains1. While the methods and hypotheses guiding his research was thoroughly flawed, Heath's psychological approach to neuroscience was novel at the time where neurosurgery was in its early stages, and lobotomies were common solutions to psychiatric disorders1. Today, the modern DBS technology is modeled after his original works, and was popularized as a neurological treatment option in the 1990s1.


It is estimated that more than 120,000 patients have undergone respective DBS implantation procedures and continue to use the device as treatments for a variety of neuronal conditions1. DBS is most commonly known for its use in regulating the production of dopamine in the substantia nigra of the brain, which is located in the basal ganglia1. This however, is by no means its only area of use, as it has been studied in patients with other movement disorders, mental health conditions, addictive disorders, and managing chronic pain1.


Standard DBS comes with a number of risks, including but not limited to infection, brain bleeds, and stroke from the implantation surgery, as well as the possibility of the DBS system breaking or the IPG not working2. The benefits of DBS, however, offer patients a treatment option with more successful outcomes than pharmaceutical alternatives1. For patients with neurological diseases, DBS provides an opportunity to manage abnormalities in their brain to improve their quality of life and limit the impact of their condition on everyday activities.



3. Neuroscientifically Challenged, 2024.

4. Marshall Health, & Medtronic, 2021.



What is aDBS (adaptive DBS)?


With the capabilities of artificial intelligence rapidly advancing, the integration of AI into medical device technology is beginning to become a reality. Machines can now be trained on advanced models or previous patient data to diagnose disease, anticipate patient reactions and outcomes, and even regulate organ function. 


Neuromodulatory DBS devices have limitations in the precision of their electronic signaling. The brain is a plastic organ, which is in a constant state of growing, adjusting, and adapting the shapes and connections of its neurons in response to experiences. This becomes a challenge to the electronic signaling from the IPG, as the optimal electronic signaling may vary even within seconds5. Given the complicated nature of the brain, it is difficult to allow for any variance in neuronal activity that will not achieve the desired outcome, even when comparing the brain's mechanisms to a pacemaker's role in regulating the heart. An alternative being explored by researchers to advance current DBS technology include creating adaptive models of devices, more commonly known as aDBS.


aDBS devices are a class of BCI (brain computer interfaces) that use adaptive deep brain stimulation (aDBS) to modulate brain activity through a multi-interface cloud platform, allowing for an intricate real-time feedback system to manage movement disorders like Parkinson’s via an IPG5.  The IPG’s lead manages activity in the brain by using an external AI model trained on brain biosignals to adapt the frequency of pulses to align with normalized brain function5.  The device is further complicated through its feedback loop to a web-based platform, which includes a neurologist and researcher interface, a aDBS interface for the device, and in some cases a third patient/user interface via an app5. Moreover, the platform sources information from both a clinical database and a biosignal database, which are integrated into the closed-loop AI model5.



The many aDBS interfaces pose a challenge to protecting PHI, particularly with the AI modulated frequencies in the web-based cloud and the potential to access via a patient interface exclusively on a smartphone app.
The many aDBS interfaces pose a challenge to protecting PHI, particularly with the AI modulated frequencies in the web-based cloud and the potential to access via a patient interface exclusively on a smartphone app.


Citations:

  1. Frank, Lone. 2018. The Pleasure Shock: The Rise of Deep Brain Stimulation and Its Forgotten Inventor. New York: W.W. Norton & Company. 6-38.

  2. OHSU Brain Institute. 2025. "Understanding Deep Brain Stimulation (DBS)." OHSU. https://www.ohsu.edu/brain-institute/understanding-deep-brain-stimulation-dbs.

  3.  "2-Minute Neuroscience: Deep Brain Stimulation." YouTube Video, 2:01. https://www.youtube.com/watch?v=tgKIbdTWq7o.

  4. Marshall Health, & Medtronic. 2024. "Medtronics Deep Brain Stimulation Patient." YouTube Video. https://www.youtube.com/watch?v=_tkmSn2m0Ck.

  5. Marceglia, Sara, Costanza Conti, Oleg Svanidze, Guglielmo Foffani, Andres M. Lozano, Elena Moro, Jens Volkmann, Mattia Arlotti, Lorenzo Rossi, and Alberto Priori. “Double-blind Cross-over Pilot Trial Protocol to Evaluate the Safety and Preliminary Efficacy of Long-term Adaptive Deep Brain Stimulation in Patients With Parkinson’s Disease.” BMJ Open 12, no. 1 (January 1, 2022): e049955. https://doi.org/10.1136/bmjopen-2021-049955


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