Evidence map›Paper›PMID 40894140›Full record

ArticlemedRxiv : the preprint server for health sciences2025

Adaptive deep brain stimulation timed to gait phase improves walking in Parkinson's disease.

Kenneth H Louie, Jannine P Balakid, Jessica E Bath, Seongmi Song, Hamid Fekri Azgomi, Jacob H Marks, Julia T Choi, Philip A Starr, Doris D Wang

Abstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kenneth H LouieDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.ORCID 0000-0003-1702-1521
Jannine P BalakidDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Jessica E BathDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Seongmi SongDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Hamid Fekri AzgomiDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Jacob H MarksDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Julia T ChoiDepartment of Applied Physiology & Kinesiology, University of Florida, Gainesville, USA.ORCID 0000-0003-4963-9094
Philip A StarrDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Doris D WangDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.ORCID 0000-0001-6112-3002

Funding

Accelerating Dissemination of Implantable Neurotechnology for Clinical ResearchU24NS113637 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI BORTON, DAVID ALLENSON, DENISON, TIMOTHY · 2020 to 2024
$4.4M
Cortical basal ganglia network dynamics during human gait controlR01NS130183 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Doris Du Wang · 2023 to 2026
$1.4M
NINDS NIH HHS R01 NS130183NINDS NIH HHS U24 NS113637
6 · The paper itself

Abstract

Gait dysfunction in Parkinson's disease (PD) is a major source of disability and is often resistant to traditional deep brain stimulation (DBS). Here, we report a novel neuromodulation paradigm, gait-phase-synchronized adaptive DBS (aDBS), that dynamically modulates stimulation amplitude during contralateral leg swing. In five individuals with PD, we identified personalized neural biomarkers of gait phase from cortical and pallidal field potentials and embedded them into a chronically implanted bidirectional neurostimulator. These biomarkers, derived via a data-driven search, enabled real-time detection of swing phase and sub-second modulation of stimulation amplitude. Acute in-clinic testing showed that aDBS significantly reduced gait variability and improved bilateral symmetry compared to clinically optimized continuous DBS. In a double-blinded, multi-day crossover study, gait-phase-synchronized aDBS was well-tolerated, maintained general motor symptom control, and reduced falls and improved other gait metrics. These findings establish the feasibility of biomarker-driven, movementsynchronized neuromodulation and offer a promising strategy to restore dynamic motor control in PD.

Identifiers

PMID40894140
PMCPMC12393632

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.