Devices, systems and methods for increasing the efficacy and/or efficiency of deep brain stimulation (DBS) using parameters of stimulation that are custom tailored to a unique set of one or more symptoms and/or to a specific patient is shown and described herein. Also disclosed are devices, systems and methods for recording pertinent neural activity during non-regular patterns of stimulation and processing techniques for these recorded signals and stimulation parameter optimization based on these neural recordings may be used to tune computational models of the stimulation patterns to reproduce the observed neural activity.