The Study Of DBS Programming For Patients With Parkinson Disease

ObjectiveParkinson's disease(PD) is a common neurodegenerative disease.The cardinal signs of PD include tremor,rigidity,bradykinesia and abnormity of posture and gait. Because of its reversibility and adjustability,deep brain stimulation(DBS) has become an widely accepted and recognized treatment for PD patients.There are 67 PD patients in Shandong who have DBS operation in Beijing,Shanghai and Xi'an.We started to participate in the post-operative programming and follow-up of DBS in 2006.This study provides a 2-year follow-up for the patients who have PD with STN-DBS.Methods1.Twenty-nine PD patients with STN-DBS(single-part STN stimulation 19 cases, bilateral STN stimulation 10 cases) before September,2006 were assessed 1 and 2 years after surgery.The diagnosis of PD referred to the UK PD Brain Bank criteria. Individuals with atypical parkinsonism or cannot cooperate with us were excluded.All the patients had taken antiparkinsonian medication for two to ten years before surgery. As the disease progressed,the effectiveness of the medication becomed less lasting. They suffered from debilitating motor symptoms such as dyskinesia.Their Hoehn &Yahr stages were fromⅡtoⅤ.Their ages were from 30 to 70,average 55.3.There were 18 males,11 females in this group.The courses of their diseases were from 3 to 10 years, average 5.6 years.2.The motor disability was evaluated with UPDRSIII in the condition with and without levodopa treatment,with and without STN stimulation.We also provide an analysis for stimulation parameters of 1 and 2 years after surgery. 3.Statistic Manual:The data were analyzed using SPSS13.0.Values are given as means±SD unless otherwise specified.This study applied as follows statistical methods: Chi-square test,t-test and Wilcoxon paired test.A level of significance of P＜0.05 was used.Results1.1 and 2 years after surgery,the motor disability was improved by 41.1%,39.8% respectively in single-part STN stimulation;49.4%,49.0%in bilateral STN stimulation (without drug,stimulator ON VS stimulator OFF).2.1 and 2 years after surgery,the stimulus voltages are 2.67±0.31V,2.71±0.28V; the stimulus pulses are 70.8±14.6μs,73.8±15.2μs;the stimulus frequencies are 147.4±13.6Hz,149.5±12.5Hz.3,L-dopa and L-dopa equivalents were reduced by 42.9%,41.1%respectively.ConclusionsDBS leads to marked improvement for the motor function of PD,and this improvement is more markable in bilateral STN-DBS.Stimulus voltage is the main stimulation parameter.The stimulus pulse and the stimulus frequency affect the motor function of PD less.