Short-term Efficacy Of Instantly Initial Programming After Subthalamic Nucleus Deep Stimulation For Parkinson’s Disease

Objective:To investigate and evaluate the short-term postoperative efficacy of subthalamic nucleus deep brain stimulation(STN-DBS)in Parkinson’s disease.Including the improvement of motor symptoms and non-motor symptoms and related adverse events,so as to provide reference for clinical application.Methods:A total of 226 patients with Parkinson’s disease underwent bilateral subthalamic nucleus deep brain stimulation and completed the instantly initial programming after the operation from January 2021 to December 2021 at the Neurosurgery Department of Qilu Hospital of Shandong University.The patients were followed up before the procedure and again 1 month after the procedure.The Unified Parkinson’s Disease Rating Scale,the Non-Movement Rating Scale(NMSS),Parkinson’s disease 39 quality of Life Questionnaire(PDQ-39),Hamilton depression Scale(HAMD),Hamilton anxiety Scale(HAMA)and Montreal Cognitive Assessment(MoCA),Activities of daily living(ADL),Levodopa equivalent dose(LED)were used for the assessment of the general conditions,medication conditions,motor symptoms,motor complications,the non-motor symptoms,quality of daily life,daily living ability,cognition,neurologic state and so on.and postoperative adverse events were observed,so as to evaluate the postoperative effect.Results:All of 226 patients completed the follow-up,and the result is as follows:(1)Motor function:the total score on UPDRS-Ⅲ was significantly lower than that before operation in which the patients did not take medication,The average improvement rate was 63.2%and 51.2%respectively.The UPDRS-IV score of the patients was significantly lower than that before operation,with an average improvement rate of 42.3%,suggesting that the symptoms of motor complications were significantly improved.(2)The total score of NMSS was decreased significantly compared with that before operation,and the improved symptoms included specific components of cardiovascular,sleep disorders,urinary symptoms,sexual function and other symptoms.(3)The quality of daily life and daily living ability were significantly improved compared with that before operation.(4)There was no significant decrease in cognitive ability and neurologic condition compared with that before operation.(5)Postoperative adverse reactions were mostly transient,and no serious or lifethreatening complications occurred.Conclusion:Instantly initial programming after subthalamic nucleus deep stimulation had good short-term efficacy and was safe for the treatment of PD,it mainly improved patient’s motor symptoms,motor complications,and non-motor symptoms,as well as quality of life.