Factors predicting the instant effect of motor function after subthalamic nucleus deep brain stimulation in Parkinson’s disease

摘要

Background:Subthalamic nucleus deep brain stimulation(STN-DBS)is an effective treatment for Parkinson’s disease(PD),the predictive effect of levodopa responsiveness on surgical outcomes was confirmed by some studies,however there were different conclusions about that through long-and short-term follow-ups.We aimed to investigate the factors which influence the predictive value of levodopa responsiveness,and discover more predictive factors of surgical outcomes.Methods:Twenty-three PD patients underwent bilateral STN-DBS and completed our follow-up.Clinical evaluations were performed 1 week before and 3 months after surgery.Results:STN-DBS significantly improved motor function of PD patients after 3 months;preoperative levodopa responsiveness and disease subtype predicted the effect of DBS on motor function;gender,disease duration and duration of motor fluctuations modified the predictive effect of levodopa responsiveness on motor improvement;the duration of motor fluctuations and severity of preoperative motor symptoms modified the predictive effect of disease subtype on motor improvement.Conclusions:The intensity of levodopa responsiveness served as a predictor of motor improvement more accurately in female patients,patients with shorter disease duration or shorter motor fluctuations;PD patients with dominant axial symptoms benefit less from STN-DBS compared to those with limb-predominant symptoms,especially in their later disease stage.