2023 年 40 巻 3 号 p. 355-358
Since dopamine deficiency was first implicated in the pathophysiology of Parkinson disease (PD) in 1960, oral therapy using levodopa and other drugs is the mainstay of treatment for PD. However, device–aided therapy is increasingly being used in recent years for the management of advanced PD refractory to medical therapy. Currently, deep brain stimulation (DBS) therapy is widely used globally for advanced PD after nearly 30 years since 1990. In addition to conventional stimulation, adaptive deep brain stimulation (aDBS) is a novel method available in Japan since 2020. The aDBS technique is feedback–based, on–demand real–time stimulation. The signal inputs are referred to as local nerve action potentials with need–based adjustment of stimulation in contrast to cDBS. Advances in aDBS will provide personalized therapy and enable stimulation under a more physiological environment and expand the application of DBS for the management of many diseases in addition to movement disorders.