Surgical & device therapy
Deep-brain stimulation (DBS), focused ultrasound, levodopa-carbidopa intestinal gel (LCIG) pumps and other procedural interventions.
In this category
State of the art
No update yet for Surgical & device therapy. An update is a standalone state-of-the-art for the topic — what someone with Parkinson's needs to know about where this approach stands today.
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The Place of Adaptive Deep Brain Stimulation in Parkinson's Disease: Spatial before Temporal Optimization Adaptive (closed-loop) DBS
This expert viewpoint argues that adaptive DBS — which modulates stimulation amplitude in real time based on subthalamic beta activity — delivers its best results only after conventional spatial optimisation (contact selection, directional field steering) has been completed. It positions aDBS as the final layer of a programming sequence rather than a standalone upgrade, offering clinicians a practical framework now that sensing-enabled devices such as the FDA-approved BrainSense system are in routine use. -
Patient-Calibrated Dynamical Modeling and Embedded Trend-Zone Predictive Control for Closed-Loop Deep Brain Stimulation in Parkinson's Disease Adaptive (closed-loop) DBS
This preprint introduces a patient-calibrated mathematical model of individual beta-oscillation dynamics paired with a "trend-zone" model predictive controller — an algorithm that anticipates the direction brain activity is heading and adjusts stimulation within defined acceptable bands, rather than simply reacting to a fixed threshold. The approach is designed to personalise closed-loop DBS to each patient's recorded brain data, potentially improving both symptom control and energy efficiency compared to simpler adaptive algorithms. -
Converging metabolic and functional networks for tremor expression and deep brain stimulation-mediated control Deep-brain stimulation
This within-subject FDG-PET study of 14 thalamic DBS patients shows that local metabolic changes at the stimulation site do not predict tremor improvement, but how well the individual's brain-wide metabolic response aligns with a published tremor treatment network does (R²=0.593, p=0.007). The finding supports network-engagement — rather than local suppression — as the mechanism behind effective DBS, and points toward connectome-based electrode targeting and programming optimisation as a clinically actionable next step. -
Una tecnología para tratar el párkinson elimina el dolor a Inma, paciente con la "enfermedad del suicidio": "Es un cambio descomunal" - La Opinión de Málaga Focused ultrasound
A Spanish case report describes HIFU — the same focused-ultrasound technology already used for tremor-dominant Parkinson's — being applied to severe neuropathic pain (trigeminal neuralgia) at Hospital Can Ruti in Badalona, reportedly the first centre in Catalonia to do so. A single patient experienced immediate pain relief after all other treatments had failed, suggesting specialist HIFU centres are beginning to extend the technique beyond tremor to refractory pain conditions. -
Vyalev eases motor, nonmotor symptoms in advanced Parkinson’s Pump therapies (LCIG, apomorphine)
Six-month real-world data from the ROSSINI observational study (n=105 newly treated patients) show Vyalev (foslevodopa/foscarbidopa subcutaneous infusion) cut daily off time by ~53% and dyskinesia time by ~53% in advanced Parkinson's — the first prospective real-world evidence for this pump therapy since its recent approval. -
Parkinson's Disease.
The article reviews deep brain stimulation (DBS) as the most established surgical option and discusses MRI-guided focused ultrasound (FUS) as a newer, incisionless ablative alternative for appropriate patients—particularly those with tremor-dominant disease or who are not DBS candidates. It covers patient selection criteria and the types of benefit each approach provides.