Artificial intelligence in deep brain stimulation for movement disorders: a systematic review and technology readiness assessment
Artificial intelligence (AI) is increasingly explored across deep brain stimulation (DBS) for movement disorders, yet whether current systems are approaching deployment remains unclear. To characterise their scope, validation maturity, and translational readiness, we systematically evaluated 239 peer-reviewed studies published between 2000 and 2025, assessing AI methods, validation practices, and barriers constraining clinical translation. Research was dominated by Parkinson's disease and subthalamic nucleus targeting, with limited coverage of other disorders and targets. Most studies reported encouraging internal performance; however, external validation was rare, evaluations remained predominantly retrospective and single-centre, and more than one-quarter involved small-sample, high-dimensional datasets with elevated overfitting risk. Technology readiness assessment revealed that most systems remain at early-to-intermediate translational stages, constrained more by limited validation than by algorithmic inadequacy, compounded by the biological heterogeneity and dynamic complexity inherent to DBS. Nevertheless, emerging external and prospective studies suggest a field moving toward clinical maturity, with promising applications in targeting, programming, outcome prediction, and adaptive therapy delivery.