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Already promising results using aDBS have been achieved for symptoms such as bradykinesia, rigidity and motor fluctuations. However, the heterogeneity of freezing of gait (FoG) with its wide range of clinical presentations and its exacerbation with cognitive and emotional load make it more difficult to predict and treat. Currently, a successful aDBS strategy to ameliorate FoG lacks a robust oscillatory biomarker. Furthermore, the technical implementation of suppressing an upcoming FoG episode in real-time represents a significant technical challenge. This review describes the neurophysiological signals underpinning FoG and explains how aDBS is currently being implemented. Furthermore, we offer a discussion addressing both theoretical and practical areas that will need to be resolved if we are going to be able to unlock the full potential of aDBS to treat FoG.<\/jats:p>","DOI":"10.1007\/s00415-025-13000-8","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T15:10:34Z","timestamp":1741792234000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Could adaptive deep brain stimulation treat freezing of gait in Parkinson\u2019s disease?"],"prefix":"10.1007","volume":"272","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0868-5270","authenticated-orcid":false,"given":"Philipp","family":"Klocke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0267-2762","authenticated-orcid":false,"given":"Moritz A.","family":"Loeffler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4093-7071","authenticated-orcid":false,"given":"Simon J. 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Moritz Loeffler declares no competing interests. Simon Lewis is supported by a National Health and Medical Research Council Leadership Fellowship (1195830) and has received research funding from the Michael J. Fox Foundation and the Australian Research Council, as well honoraria from International Parkinson Disease and Movement Disorders Society, Parkinson\u2019s Foundation and consulting fees from Pharmaxis Ltd. Alireza Gharabaghi was supported by the German Federal Ministry of Education and Research (BMBF), the European Union Joint Program \u2013 Neurodegenerative Disease Research (JPND), and by research grants from Medtronic, Abbott, Boston Scientific. Daniel Weiss received honoraria as speaker, consultant, and research grants from Abbvie, Abbott, Bial, Boston Scientific, Medtronic, Kyowa Kirin, and Stadapharm.\u00a0Figures were created with Biorender.com.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"267"}}