May 10, 2026
Author(s)Marco Meglio, Rebecca Wilkins
Rebecca Wilkins, Divisional Vice President of R&D Neuromodulation at Abbott, discusses the evolving role of deep brain stimulation in Parkinson disease, including patient selection, newer DBS technologies, and integration with emerging therapies.
As Parkinson disease (PD) progresses, many patients reach a point where medication alone is no longer sufficient to control symptoms such as tremor, rigidity, slowness, and motor fluctuations. For these individuals, deep brain stimulation (DBS) has become an increasingly important treatment option, offering targeted neuromodulation to help improve motor control and reduce the burden associated with escalating medication schedules.
Often described as a “pacemaker for the brain,” DBS works by delivering electrical stimulation to specific brain regions involved in motor circuitry. Over the last several years, the field has continued to evolve through innovations such as directional leads, adaptive programming strategies, and remote care technologies aimed at personalizing therapy and improving long-term patient management. At the same time, clinicians are reassessing the timing of referral for DBS evaluation, particularly as newer infusion therapies and investigational disease-modifying approaches continue to emerge within Parkinson disease care.
During PD Awareness Month (April), NeurologyLive® spoke with Rebecca Wilkins, Divisional Vice President of R&D Neuromodulation at Abbott, about the current state of DBS technology and how the treatment landscape is changing. In the discussion, Wilkins outlined the mechanistic rationale behind DBS, key considerations for patient selection, and the ways newer neuromodulation technologies may influence programming strategies and patient outcomes moving forward.
Can you outline how DBS modulates basal ganglia circuitry and how this translates into improvements in motor symptoms for patients with Parkinson's disease?
Rebecca Wilkins: Deep brain stimulation (DBS) works by delivering precisely timed electrical pulses to specific areas within the brain's basal ganglia circuitry, which are involved in motor control, to help control PDP symptoms.1 DBS systems include two main components that facilitate this process:
- An implantable pulse generator (IPG), a small device placed under the skin of the chest, produces these electrical pulses.
- Thin wires, known as leads, are surgically implanted to deliver these electrical pulses directly to the targeted brain regions. These DBS systems can utilize two different types of batteries: rechargeable and non-rechargeable.
- These electrical outputs function much like a pacemaker for the brain, disrupting abnormal, overactive brain signals to provide significant improvements in motor symptoms for patients with PD, particularly when medication alone is no longer sufficient.
- DBS offers an advantage by reducing the burden of the strict medication schedule often associated with pharmaceutical management, while also providing relief for all the major symptoms of PD. It is particularly beneficial in improving movement symptoms, such as tremor, stiffness, and slowness, especially when these symptoms respond to levodopa.
- It should be noted that tremor itself can improve with DBS even if it has not responded to levodopa.
- Furthermore, DBS effectively addresses medication side effects, including dyskinesia (extra, involuntary movements), either directly or by enabling lower medication doses. This improves "on time" without bothersome dyskinesias and ensures sustained symptom improvement for patients with PD.3
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