Updates in the world of DBS

Dara Nitu 

Medtronic BrainSense

October 2025 – TIME awards BrainSense™ Adaptive Deep Brain Stimulation (aDBS) the “Best Invention” title. Medtronic has been pioneering DBS technology for over 30 years, impacting the lives of millions of people living with Parkinson and beyond. Recently, they took yet another leap, enhancing the Percept™ neurostimulators with BrainSense™ technology, further personalizing therapy based on individual patient needs and neural activity. This novel technology detects, captures and classifies different brain signals, adapting device output in real time. This “marks a new era in neuromodulation and the use of therapeutic brain-computer interface technology to restore human health. ” [1]

Taking a closer look, BrainSense™ technology is made up of of five key features: “LFP survey, signal test, streaming, timeline and event recording”. This  facilitates DBS programming by “supporting contact selection, assessment of clinical response to stimulation, stimulation optimization and symptom characterization in PD”. [2] On the one hand, BrainSense™ proves advantageous when considering device maintenance - rechargeable, reduced need for battery replacements - as well as the personalized, adjustable and reversible nature of aDBS, supplemented by the real-time feature. On the other hand, “motor symptoms, medication state, movement and location of the DBS” may affect LFP signals, MRI compatibility is not yet optimal and further technological shortcomings must be taken into account.

All in all, Medtronic’s BrainSense™ technology represents a substantial leap forward on the neuromodulation technology scene, supplementing the already impactful progress which the company has made in closed-loop DBS applications. Future papers may explore multi-perspective considerations on this new technology and its application, for Parkinson Disease and beyond.

Ethics in Closed Loop Neurotechnology

Monitoring these medical technological advancements closely are those concerned with their ethical ramifications; closed Loop DBS is no exception. As  (psychiatric) neurosurgery moves towards personalized, wearable and integrated technologies, a pandora’s box of ethical dilemmas - informed consent, autonomy and accountability, to name a few - blows open. A special issue of “Brain Sciences-Neuropsychiatry” ponders: “To what extent is it acceptable to intervene in brain circuitry to modulate emotional states? Can patients with impaired autonomy truly give valid informed consent?” [3] . Thus, issues of informed consent, decisional capacity, and, by extension, bodily autonomy, arise not only when speaking of aDBS, but when looking at psychiatric neurosurgery as a whole. While ethical committees have been tasked with tackling these issues, further gaps prevail. Elements such as reliance on artificial intelligence, data privacy gray areas and equitable access [4] are seldom addressed outside of literature, namely in actual clinical practice.

Through our contribution, we hope to represent the cornerstone to a much needed bridge between patients and physicians, aiding the inclusion of oftentimes underheard voices in decisions which impact their lives firsthand. By the means of our questionnaire, we hope to gain a better understanding of what actually matters to them, creating the spark that will light the fuse of change.

Mount Sinai: DBS for depression

Exciting news out of New York – a team from the Icahn School of Medicine at Mount Sinai, first in the country to implant DBS for depression study. As part of the TRANSCEND clinical trial investigating Abbot’s™ systems for treatment-resistant depression, Prof. Dr. Kopell’s group performed this ground-breaking surgery. Currently, 24 other sites in the US are set out to follow in their footsteps. [5]

The stimulation occurs in the subcallosal cingulate cortex, a target which was identified thanks to Prof. Dr. Mayberg – pioneer in “[…] her study of brain circuits and deep brain stimulation research over the past 20 years”. She identified the subcallosal cingulate as a “signalling hub for depression” and postulated that signal modulation may alleviate symptoms, which was subsequently confirmed by years of “independent, single-arm, open-label, grant-funded studies”.

In a recent lecture at Brown University, Prof. Dr. Mayberg shared further insights on the subject [6]. She spoke on the early days of her career, when she identified area 25 – the subcallosal cingulate cortex – as a mediator of emotional and memory functions. Over the next years, following the implementation of DBS for Parkinson, she helped adapt the technology for treatment-resistant depression, aided by her previous findings. Her 2005 paper [7] already showed significant promise in terms of symptom improvement, and now, 20 years later, they are ready to do it again, even better. We are looking forward to hearing more about the new clinical trial in the years to come!

References:

1-  Medtronic BrainSenseTM Adaptive Deep Brain Stimulation named a 2025 TIME Best Inventions [Internet]. Medtronic News. 2025 [cited 2025 Nov 5]. Available from: https://news.medtronic.com/2025-10-09-Medtronic-BrainSense-TM-Adaptive-Deep-Brain-Stimulation-named-a-2025-TIME-Best-Inventions

2-  Saengphatrachai W, Jimenez-Shahed J. Current and future applications of local field potential-guided programming for Parkinson’s disease with the PerceptTM rechargeable neurostimulator. Neurodegenerative Disease Management [Internet]. 2024 Sep 2 [cited 2025 Mar 26];14(5):131–47. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11524207/

3-  ‌Torres CV, García MN, Rivas PP, Mónica Lara Almunia, Fernández A. Shaping the Future of Psychiatric Neurosurgery: From Connectomic Precision to Technological Integration. Brain Sciences [Internet]. 2025 Jun 16 [cited 2025 Jul 23];15(6):647–7. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12190430/

4-  Haag L, Starke G, Ploner M, Ienca M. Ethical gaps in closed-loop neurotechnology: a scoping review. npj Digital Medicine. 2025 Aug 8;8(1).

5-  ‌Kim J. Mount Sinai professor discusses emerging potential of deep brain stimulation for depression treatment [Internet]. The Brown Daily Herald. 2025 [cited 2025 Nov 5]. Available from: https://www.browndailyherald.com/article/2025/11/mount-sinai-professor-discusses-emerging-potential-of-deep-brain-stimulation-for-depression-treatment

6-  Mount. Mount Sinai Is First in the Nation to Perform Deep Brain Stimulation Implant as Part of Clinical Trial for Depression [Internet]. Mount Sinai Health System. 2025. Available from: https://www.mountsinai.org/about/newsroom/2025/mount-sinai-is-first-in-the-nation-to-perform-deep-brain-stimulation-implant-as-part-of-clinical-trial-for-depression

7-  Mayberg HS, Lozano AM, Voon V, McNeely HE, Seminowicz D, Hamani C, et al. Deep Brain Stimulation for Treatment-Resistant Depression. Neuron [Internet]. 2005 Mar;45(5):651–60. Available from: https://www.sciencedirect.com/science/article/pii/S089662730500156X

Project Updates

Questionnaire

The top of the month brought on perhaps the biggest milestone in our project thus far. Following ethical approval and the final tweaks, our questionnaire has gone live! The items explore patient perspectives on DBS technologies, with a particular focus on Closed-Loop DBS acceptance.

We are working with colleagues from the MUMC+, as well as the Dutch Parkinson's Association, on our mission to explore underrepresented voices and insights. We are always looking to expand our collaborator network, from within the Netherlands, as well as the global medical stage.

 The questionnaire may be completed at: https://maastrichtuniversity.eu.qualtrics.com/jfe/form/SV_cUXOa6ZC9cvTtl4.

EuroDBS conference

Our research group has been extended an invitation to present our project and preliminary findings at the December 2025 EuroDBS conference taking place in Freiburg. We are delighted to have been offered this opportunity and are currently undergoing the necessary preparation, hoping to deliver an insightful contribution. Look out for our November and December editions for further details.

DIEPcast Season 1

Over the month of October, our website and LinkedIn page have hosted 4 podcast episodes exploring DBS from various different angles – physicians, researchers, patients and advocates alike were invited to share their thoughts. Their contributions have helped paint a complex, multi-faceted image of the topic at hand and we are thrilled to have facilitated such fruitful discourse. By this way, we express our gratitude towards our guests, as well as our listeners. If you haven’t yet, make sure to check the episodes out!