{
  "abstract": "Parkinson's disease leads to a spectrum of locomotor deficits that vary in severity with the nature of daily activities and the fluctuating physiology of patients. Many of these deficits remain inadequately addressed by existing deep brain stimulation therapies that rely on activity-agnostic parameters optimized for cardinal motor symptoms. By contrast, therapies embedding activity-specific parameters have the potential to better address the entire range of symptoms. Here we expose physiological principles that enable real-time decoding of ongoing locomotor activities across motor fluctuations from the neural dynamics of the subthalamic nucleus. This decoding steered activity-dependent adaptations of deep brain stimulation therapies that improved locomotor deficits while preserving efficacy for cardinal motor symptoms across activities of daily living. Our activity-dependent framework provides a blueprint for next-generation neuromodulation therapies that continuously select parameters optimized to the behavioral context and fluctuating physiology of each patient. ClinicalTrials.gov registration NCT06791902 .",
  "abstract_shown": true,
  "affiliations": [
    "Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland",
    "Institute of Digital Technologies for Personalized Healthcare (MeDiTech), University of Southern Switzerland (SUPSI), Viganello, Switzerland",
    "NeuroRestore, Lausanne University Hospital (CHUV) and Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland",
    "Neuro-X Institute, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland",
    "Department of Neurosurgery, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland",
    "Department of Neurology, Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland",
    "Faculty of Medicine, University of Geneva, Geneva, Switzerland",
    "Department of Neurology, Hôpital du Valais, Sion, Switzerland",
    "Department of Neurology, Hôpital Fribourgeois, Fribourg, Switzerland",
    "Department of Neurology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland",
    "Wyss Center for Bio and Neuroengineering, Geneva, Switzerland",
    "Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland. Eduardo.Moraud@epfl.ch",
    "Neuro-X Institute, École Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland. Eduardo.Moraud@epfl.ch",
    "NeuroRestore, Lausanne University Hospital (CHUV) and Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland. Eduardo.Moraud@epfl.ch"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 27,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Stefano Scafa",
      "orcid": "0009-0003-0707-7158"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Valeria de Seta",
      "orcid": "0000-0001-8796-8775"
    },
    {
      "affs": [
        3,
        2
      ],
      "name": "Ruijia Wang",
      "orcid": "0000-0001-5018-5398"
    },
    {
      "affs": [
        3,
        2
      ],
      "name": "P. Lopez",
      "orcid": "0000-0003-0189-3245"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Andrea Sánchez López",
      "orcid": "0009-0002-1453-6079"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Camille Varescon",
      "orcid": "0009-0000-6915-8306"
    },
    {
      "affs": [
        3,
        2
      ],
      "name": "Icare Sakr",
      "orcid": "0009-0009-2266-4549"
    },
    {
      "affs": [
        4
      ],
      "name": "Nadia Bérard",
      "orcid": "0000-0002-2082-4221"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Léa Bole-Feysot"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Celine Deschenaux"
    },
    {
      "affs": [
        3
      ],
      "name": "Ian Enderli"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Yohann Thenaisie",
      "orcid": "0000-0002-9936-5821"
    },
    {
      "affs": [
        2
      ],
      "name": "Morgane Burri"
    },
    {
      "affs": [
        2
      ],
      "name": "Frédéric Merlos",
      "orcid": "0009-0008-1018-5260"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Vanessa Fleury",
      "orcid": "0000-0001-5744-6829"
    },
    {
      "affs": [
        7
      ],
      "name": "Benoît Wicki",
      "orcid": "0000-0003-4687-0354"
    },
    {
      "affs": [
        8,
        9
      ],
      "name": "Ettore A. Accolla",
      "orcid": "0000-0003-1234-8808"
    },
    {
      "affs": [
        9
      ],
      "name": "Andria Tziakouri",
      "orcid": "0000-0001-8350-9272"
    },
    {
      "affs": [
        9
      ],
      "name": "Cécile A. Hubsch",
      "orcid": "0000-0002-9091-7087"
    },
    {
      "affs": [
        9
      ],
      "name": "Mayté Castro Jiménez",
      "orcid": "0000-0003-4165-4804"
    },
    {
      "affs": [
        9
      ],
      "name": "Julien F. Bally",
      "orcid": "0000-0002-0970-8844"
    },
    {
      "affs": [
        1
      ],
      "name": "Alessandro Puiatti",
      "orcid": "0000-0002-9745-1515"
    },
    {
      "affs": [
        10
      ],
      "name": "Kyuhwa Lee",
      "orcid": "0000-0002-3854-4690"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Henri Lorach",
      "orcid": "0000-0003-4337-2798"
    },
    {
      "affs": [
        3
      ],
      "name": "Antoine Collomb‐Clerc",
      "orcid": "0000-0002-5687-0852"
    },
    {
      "affs": [
        0,
        4,
        3,
        2
      ],
      "name": "Jocelyne Bloch",
      "orcid": "0000-0002-6405-1590"
    },
    {
      "affs": [
        11,
        12,
        13
      ],
      "name": "Eduardo Martin Moraud",
      "orcid": "0000-0002-6148-7065"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/34qww9ww6krgc.bib",
  "cited_by": 10,
  "doi": "10.1038/s41591-026-04432-4",
  "fulltext_url": null,
  "id": "34qww9ww6krgc",
  "issns": [
    "1078-8956",
    "1744-7933",
    "1546-170X"
  ],
  "landing_url": "https://hal.science/hal-05795919v1",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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    [
      "openalex",
      "2728|Deep Brain Stimulation and Movement Disorders"
    ],
    [
      "openalex",
      "2728|Neurological disorders and treatments"
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  "openalex": "W7164830639",
  "pdf_url": null,
  "pmcid": "PMC13472876",
  "pmid": "42297979",
  "published": "2026-06-15",
  "publisher": "Nature Publishing Group",
  "ris": "https://research.draconitic.com/paper/34qww9ww6krgc.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:55Z",
      "native_id": "hal-05795919",
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      "url": "https://hal.science/hal-05795919v1"
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      "url": "https://doi.org/10.1038/s41591-026-04432-4"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2728|Deep Brain Stimulation and Movement Disorders",
      "subfield": "neurology"
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  ],
  "title": "Activity-dependent adaptive deep brain stimulation improves gait in Parkinson’s disease",
  "title_text": "Activity-dependent adaptive deep brain stimulation improves gait in Parkinson’s disease",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T13:20:39Z",
  "url": "https://research.draconitic.com/paper/34qww9ww6krgc",
  "venue": "Nature Medicine",
  "versions": []
}