This study demonstrates the feasibility and effectiveness of brain-computer interface (BCI)-controlled adaptive deep brain stimulation (aDBS) in patients with advanced Parkinson's disease (PD). The researchers used a BCI to interpret pathological brain activity and control when therapeutic deep brain stimulation (DBS) was delivered, aiming to personalize and optimize stimulation in real time. The study involved 8 PD patients who received aDBS of the subthalamic nucleus (STN). Feedback was provided by processing local field potentials (LFPs) recorded directly from the stimulation electrodes. The results showed that aDBS improved motor scores by 66% (unblinded) and 50% (blinded) compared to conventional continuous DBS (cDBS), with a 56% reduction in stimulation time and a corresponding decrease in energy requirements. aDBS was also more effective than no stimulation and random intermittent stimulation. The study suggests that BCI-controlled DBS can be more efficient and efficacious than conventional continuous neuromodulation for PD, potentially reducing side effects and extending the battery life of implanted systems.This study demonstrates the feasibility and effectiveness of brain-computer interface (BCI)-controlled adaptive deep brain stimulation (aDBS) in patients with advanced Parkinson's disease (PD). The researchers used a BCI to interpret pathological brain activity and control when therapeutic deep brain stimulation (DBS) was delivered, aiming to personalize and optimize stimulation in real time. The study involved 8 PD patients who received aDBS of the subthalamic nucleus (STN). Feedback was provided by processing local field potentials (LFPs) recorded directly from the stimulation electrodes. The results showed that aDBS improved motor scores by 66% (unblinded) and 50% (blinded) compared to conventional continuous DBS (cDBS), with a 56% reduction in stimulation time and a corresponding decrease in energy requirements. aDBS was also more effective than no stimulation and random intermittent stimulation. The study suggests that BCI-controlled DBS can be more efficient and efficacious than conventional continuous neuromodulation for PD, potentially reducing side effects and extending the battery life of implanted systems.