帕金森病（PD）是一种以黑质多巴胺能神经元变性为特征的神经系统退行性疾病，其典型临床表现包括运动迟缓、震颤等，严重影响患者的生活质量。深部脑刺激（DBS）是目前临床治疗PD的关键技术，可通过高频电刺激特定脑区改善运动功能。但传统DBS的固定刺激参数无法动态响应症状波动，可能导致过度刺激或刺激不足，进而影响治疗效果。自适应深部脑刺激（aDBS）可以通过实时监测神经信号，如局部场电位（LFPs），解码神经特征，构建"监测-解码-调控"的闭环系统，动态调整刺激参数，实现更精准、个性化的治疗。aDBS不仅能显著改善运动症状，还可减少言语障碍、吞咽困难等不良反应，是治疗PD的理想手段。目前，aDBS仍面临脉冲发生器芯片化、柔性电极精准植入、信息采集/解码与反馈、微型高能电池与无线充电安全性、减少手术创伤大及并发症等技术挑战。未来，突破植入式脑机接口（BCI）脉冲发生器芯片化、微电极阵列、大数据并行计算、高带宽通信等技术瓶颈，是植入式BCI的颠覆性创新，将有望成为PD、阿尔茨海默病、抑郁症等重要脑疾病治疗的突破。本文围绕aDBS的原理、临床优势、生物标志物研究、临床试验设计及设备创新进展进行述评，并分析其技术瓶颈与发展方向，以期为aDBS的后续研究提供参考。

Parkinson disease (PD) is a progressive neurodegenerative disorder marked by the loss of dopaminergic neurons in the substantia nigra. Clinically, PD presents with motor symptoms such as bradykinesia, tremor, and rigidity, which significantly compromise patients' daily function and quality of life. Deep brain stimulation (DBS) has become a cornerstone in the management of advanced PD, delivering high-frequency electrical stimulation to specific brain targets to alleviate motor deficits. However, conventional DBS operates with fixed parameters, lacking the ability to adapt in real-time to symptom fluctuations. This rigidity can lead to suboptimal outcomes including overstimulation or inadequate symptom control.Adaptive DBS (aDBS) represents an advanced therapeutic approach that continuously monitors neural activity, such as local field potentials (LFPs), and dynamically adjusts stimulation parameters through a closed-loop "sense-decode-stimulate" system. This facilitates personalized therapy that responds in real-time to the patient's clinical state. aDBS has been shown to not only enhance motor symptom control but also reduce stimulation-induced side effects such as dysarthria and dysphagia. Despite its promise, several clinical and technical challenges remain. These include the miniaturization of pulse generators, precision placement of flexible electrodes, reliable signal decoding and feedback, safety of compact high-energy batteries and wireless charging, and minimizing surgical invasiveness and related complications. Future developments in implantable brain-computer interface (BCI) technologies, such as integrated circuit-based implantable pulse generators, microelectrode array, high-performance computing, and secure high-bandwidth communication, hold disruptive potential that may benefit not only PD but also other neurological and psychiatric conditions including Alzheimer disease and depression. This article reviews the fundamental principles, clinical benefits, biomarker validation, trial design considerations, and technological advancements in aDBS systems, and discusses current limitations and future directions to guide further clinical translation.