Application Of MER Combined With Lead DBS In Postoperative Program Control Of Patients With Parkinson’s Disease

Objective:Parkinson’s disease(PD)is a neurological disease caused by the pathophysiological loss or degeneration of dopaminergic neurons in the substantia nigra of the midbrain.It is mainly elderly patients,with a tendency to become younger.Deep brain stimulation(DBS)is currently a commonly used method for the treatment of mid to late-stage Parkinson’s disease.Its main characteristics are small surgical damage,adjustability,relatively few side effects and complications,and a significant reduction in levodopa consumption after surgery.The outcome of postoperative programmed surgery is a direct manifestation of the efficacy of deep brain electrical stimulation in the treatment of Parkinson’s disease.This article mainly explores the feasibility of intraoperative microelectrode recordings(MER)combined with postoperative Lead-DBS multimodal image fusion technology in patients with Parkinson’s disease,and selecting the boot contact method specifically based on the patient’s symptoms.Methods:According to the differences in program control methods after DBS,the data of 80 patients with Parkinson’s disease who received DBS were analyzed.They were divided into two groups using a random number table method,with 40 patients in each group.Experimental group:Parkinson’s disease patients underwent intraoperative MER combined with postoperative Lead-DBS multimodal fusion technology,and targeted selection of power-on contacts for programmed control based on patient symptoms;Control group:Carry out contact by contact program control according to the consensus of DBS program control experts.Results:The first startup time was(136.30±11.81)min in the control group and(86.05±7.05)min in the experimental group,P<0.05,with a statistically significant difference.The startup time was significantly shortened in the experimental group;The number of adverse reactions was(0.90±0.50)in the experimental group and(3.03±1.00)in the control group,P<0.05,with a statistically significant difference.The number of adverse reactions in the experimental group was significantly reduced;The improvement rate of the Unified Parkinson’s Disease Rating Scale(UPDRS)-Ⅲ score during the drug "off" period after surgery:The average improvement rate of the UPDRS III score in the experimental group after surgery was 55.00%,while the average improvement rate in the control group was 53.46%,P>0.05,with no statistically significant difference.However,the improvement rate of motor function in the experimental group was higher than that in the control group;The improvement rate of the Parkinson’s disease quality of life questionnaire(PDQ-39):The average improvement rate of the experimental group after operation was 47.60%,while the average improvement rate of the control group was 46.60%,P>0.05.There was no statistically significant difference,but the improvement rate of the experimental group’s quality of life was better than that of the control group;The number of outpatient program control times within half a year:the experimental group:(2.20±0.85)times,and the control group:(4.08±1.89)times,P>0.05,the difference was not statistically significant,but the number of program control times in the experimental group was less than that in the control group within half a year.Conclusion:The combination of intraoperative MER and postoperative Lead-DBS multimodal fusion technology for patients,combined with the method of selecting power-on contacts tailored to the patient’s symptoms,has the advantages of safety,efficiency,and fewer side effects during power-on,and can be used as a new attempt to program patients after DBS.