Curative effect of deep brain stimulation of subthalamic nucleus on Parkinson's disease

JIANG Lei; SHAO Hua; WANG Xi-xian; SHI Xin; FENG Zhao-hai; HAO Yu-jun

doi:10.13798/j.issn.1009-153X.2019.01.003

Abstract：Objective To study the clinical effect of deep brain stimulation (DBS) of the subthalamic nuclei (STN) on Parkinson's disease (PD). Methods Sixty-four patients with PD were treated by the STN-DBS from January, 2016 to September, 2017. The motor function, use of anti-PD drugs, intraoperative state and postoperative complications were analyzed in all the patients. Results The surgery was successfully completed in all the patients. One hundred and twenty-eight stimulating electrodes were ued. The successful rate of the one-time puncture of the bilateral STN was 85.94% (55/64). The bilateral STN signals were clearly recorded by the intraoperative microelectrodes in 51 patients. The unilateral STN signals was not recorded in 13 patients, in whom the significant effect of the stimulation of STN were observed. The mean rate of symptoms improvement was (55.36 ± 5.62)% in 64 patients. The levodopa equivalent dose taken by every patient was significantly lower after the surgery than that before the surgery (P<0.05). The UPDRS-Ⅲscores under the state of medication and non-medication were significantly lower after the surgery than those before the surgery (P<0.05). The micro-destructive effects were observed in 26 patients in whom the symptoms were relieved after the surgery. The postoperative complications including the intracranial pneumatosis (45.31%, 29/64), intracranial hemorrhage (3.13%, 2/64) and so on disappeared during the following-up for postoperative 3 months. Conclusions The STN-DBS can improve of motor function, and reduce the dose of anti-PD drugs, but it has high risks of postoperative complications, and the clinical attention should be paid to the operative manipulation the operative manipulation in the patients with PD.