Dates: April 18-22, 2026 Location: McCormick Place, Chicago, Illinois, USA Organizer: American Academy of Neurology Website: [aanannualmeeting.com](https://www.aan.com/meetings/annual-meeting)
Deep Brain Stimulation (DBS) and neurotechnology represent one of the most active areas of movement disorder research and clinical practice. The AAN 2026 annual meeting features comprehensive coverage of DBS advances across several key areas: directional electrode technology, closed-loop adaptive systems, novel anatomical targets, peripheral and spinal neuromodulation, and device-based combination therapies for Parkinson's disease and related disorders.
This page synthesizes the current state of these technologies, their expected presentation at AAN 2026, and their integration with the broader NeuroWiki knowledge base on [DBS for Parkinson's disease](/therapeutics/deep-brain-stimulation-parkinson) and [general DBS principles](/therapeutics/deep-brain-stimulation).
AAN 2026 is expected to feature dedicated platform and poster sessions on neuromodulation advances. Key topic clusters expected at the meeting include:
Dates: April 18-22, 2026 Location: McCormick Place, Chicago, Illinois, USA Organizer: American Academy of Neurology Website: [aanannualmeeting.com](https://www.aan.com/meetings/annual-meeting)
Deep Brain Stimulation (DBS) and neurotechnology represent one of the most active areas of movement disorder research and clinical practice. The AAN 2026 annual meeting features comprehensive coverage of DBS advances across several key areas: directional electrode technology, closed-loop adaptive systems, novel anatomical targets, peripheral and spinal neuromodulation, and device-based combination therapies for Parkinson's disease and related disorders.
This page synthesizes the current state of these technologies, their expected presentation at AAN 2026, and their integration with the broader NeuroWiki knowledge base on [DBS for Parkinson's disease](/therapeutics/deep-brain-stimulation-parkinson) and [general DBS principles](/therapeutics/deep-brain-stimulation).
AAN 2026 is expected to feature dedicated platform and poster sessions on neuromodulation advances. Key topic clusters expected at the meeting include:
Traditional DBS electrodes deliver stimulation in a spherical pattern around each contact, which can affect both the intended target and adjacent structures, causing side effects like dysarthria, mood changes, or gait disturbance. Directional leads resolve this by splitting each electrode contact into multiple independently-controlled segments that can shape the electric field in a specific direction[@schwab2016][@steigerwald2019].
Directional DBS offers several documented advantages over conventional omnidirectional leads:
A 2023 study demonstrated that directional STN-DBS provided significantly improved tremor and rigidity control compared to conventional DBS, with fewer stimulation-induced side effects[@pollock2023]. Long-term follow-up data from the ADBS registry showed directional leads maintained efficacy advantages over 3+ years, particularly for speech and cognitive safety margins[@steigerwald2019].
The AAN 2026 meeting is expected to feature:
Conventional DBS delivers continuous, high-frequency stimulation at fixed parameters regardless of the patient's state (ON medication, OFF medication, sleep, activity). This open-loop approach is energy-inefficient, may cause tolerance, and cannot adapt to the dynamic nature of Parkinson's disease symptoms.
Closed-loop (adaptive) DBS (aDBS) represents a paradigm shift: the system monitors neural signals (local field potentials, cortical potentials, or accelerometer data) and adjusts stimulation in real time[@little2016][@arlotti2016].
Adaptive DBS systems detect the pathological beta-band oscillations (13-30 Hz) characteristic of PD and respond by increasing stimulation intensity. When the patient's motor state improves (e.g., with levodopa), the beta oscillations diminish and the system reduces stimulation, conserving battery and potentially reducing side effects["@velisar2022"].
The landmark study by Little et al. (2016) demonstrated that adaptive DBS was non-inferior to conventional DBS for motor control while using significantly less stimulation (reducing energy delivery by ~40%)[@little2016]. This has major implications for battery life and device longevity.
A 2023 publication from the Cleveland Clinic described the NeuroSphere梵斋 system, which uses machine learning to classify LFP patterns and deliver personalized adaptive stimulation. This system achieved superior motor outcomes compared to standard aDBS in a within-subject crossover trial[@wang2023].
| Device | Company | Adaptive Features | Status |
|--------|---------|-------------------|--------|
| Percept PC | Medtronic | Sense-ready; adaptive algorithms in development | FDA approved |
| Infinity | Abbott | Directional + adaptive compatible | FDA approved |
| Vercise Genus | Boston Scientific | Directed steering with sensing | FDA approved |
| NeuroSphere梵斋 | Neuralink/Research | ML-classified adaptive | Investigational |
Sessions are expected to cover:
While STN and GPi remain the primary DBS targets for PD, research at AAN 2026 and in the broader literature is exploring several novel targets for specific symptoms:
The posterior subthalamic area/zona incerta (ZI) has emerged as an effective target for tremor-dominant PD. ZI stimulation often achieves equivalent tremor control to VIM thalamic DBS with lower amplitudes. Studies suggest ZI may also benefit axial symptoms more than STN alone[@foltynie2023].
Modern imaging and microelectrode recording allow mapping of functional territories within STN. Motor territories in the dorsolateral STN provide optimal motor benefits with lower cognitive risk. AAN 2026 presentations are expected to detail the subregional anatomy and how to target these areas with directional leads.
The PPN is a brainstem target explored for gait and postural instability in PD[@artusi2022]. Early studies showed modest benefit, but recent work with optimized parameter selection (low-frequency stimulation, 25-30 Hz) and combined STN+PPN approaches has demonstrated more consistent improvements in gait freezing.
While not a movement disorder target, fornix DBS for Alzheimer's disease represents an important neuromodulation frontier. AAN 2026 sessions may cover the latest results from the AD-BCI study and similar trials exploring memory circuit stimulation.
| Target | Primary Indication | Mechanism | Evidence Level |
|--------|-------------------|-----------|----------------|
| Zona Incerta | Tremor, axial symptoms | Motor pathway modulation | Moderate |
| PPN | Gait freezing, postural instability | Reticular activating system | Limited but promising |
| Dorsolateral STN | Motor symptoms with cognitive safety | Motor territory targeting | Emerging |
| Fornix | Memory (AD) | Hippocampal circuit activation | Phase 2 trials |
| Cerebellar | Tremor, dyskinesias | Cerebello-thalamic pathways | Preclinical |
VNS has emerged as a non-brain-invasive neuromodulation approach for PD[@boehm2021]. The proposed mechanisms include:
As detailed in the [SCS for Parkinson's Disease](/therapeutics/spinal-cord-stimulation-parkinsons) page, thoracic SCS addresses gait dysfunction, freezing of gait, and postural instability—symptoms less responsive to standard DBS. AAN 2026 sessions may cover:
A specific variant of VNS—stimulation of the auricular branch of the vagus nerve (AB-VN) via the external ear—offers a fully non-invasive option. Emerging data suggests benefits for both motor and non-motor symptoms (mood, sleep) in PD. Phase 2 trials are ongoing as of 2026.
The combination of DBS with continuous medication optimization represents the standard of care, but AAN 2026 is expected to feature discussions on more sophisticated integration:
AAV-based gene therapy (e.g., [AAV2-GAD](/entities/gad-genes) for glutamic acid decarboxylase delivery to STN) represents a surgical neuromodulation approach that may complement or precede DBS in carefully selected patients. AAN 2026 sessions may discuss:
Modern DBS systems are increasingly MRI-conditional, allowing patients to undergo magnetic resonance imaging under specific conditions. Next-generation systems feature:
DBS systems are evolving toward bi-directional interfaces. The field of closed-loop neuroprosthetics integrates DBS with cortical recording systems to provide state-dependent, brain-wide modulation. While still largely investigational, AAN 2026 presentations may feature:
Magnetic Resonance-guided Focused Ultrasound (MRgFUS) offers non-invasive lesioning for tremor-dominant PD. As detailed in the [Focused Ultrasound](/therapeutics/focused-ultrasound-parkinsons) page, it provides irreversible ablation of VIM thalamus or STN. AAN 2026 may feature comparative discussions:
Several important trials are expected to report or update results at AAN 2026:
| Trial | Description | Phase | Expected Status |
|-------|-------------|-------|-----------------|
| Adaptive DBS Registry | Real-world outcomes with aDBS systems | Registry | 3-year follow-up |
| Directional Lead RCT | Randomized comparison directional vs. standard | RCT | 5-year outcomes |
| SCS for PD PPN study | Combined SCS + PPN stimulation for gait | II | 2-year results |
| tVNS Phase 3 | Transcutaneous VNS for PD motor symptoms | III | Primary endpoint |
| STN subregion targeting | Motor vs. cognitive STN subregions | II | Mechanistic results |
| Foriception | Fornix DBS for AD (memory circuit) | II | Cognitive outcomes |
| Technology | Motor Efficacy | Cognitive Safety | Reversibility | Evidence Level |
|------------|---------------|-----------------|--------------|----------------|
| STN-DBS | High | Moderate | Yes | Strong |
| GPi-DBS | High | High | Yes | Strong |
| Adaptive DBS | High | Similar to conventional | Yes | Growing |
| Directional DBS | Equal or better | Better | Yes | Growing |
| SCS | Moderate (gait) | High | Yes | Moderate |
| VNS/tVNS | Moderate | High | Yes | Moderate |
| PPN | Limited | Unknown | Yes | Limited |
| MRgFUS | High (tremor) | Moderate | No (lesion) | Moderate |