Efficacy of intraoperative sliding CT assisted deep brain stimulation of subthalaminal nucleus in short-term motor improvement in patients with Parkinson's disease under general anesthesia
10.3760/cma.j.cn115354-20241026-00653
- VernacularTitle:全麻下术中滑轨CT辅助的脑深部电刺激术治疗帕金森病的短期运动功能疗效分析
- Author:
Yourang ZHAO
1
;
Yanmin WANG
1
;
Yongqin WANG
1
;
Yi TIAN
1
;
Xianzhi LIU
1
;
Weifeng LU
1
Author Information
1. 郑州大学第一附属医院神经外科，郑州 450052
- Publication Type:Journal Article
- Keywords:
Deep brain stimulation;
Parkinson's disease;
Motor function;
General anesthesia;
Local anesthesia
- From:
Chinese Journal of Neuromedicine
2025;24(2):163-167
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of intraoperative sliding CT assisted deep brain stimulation of subthalaminal nucleus (STN-DBS) in short-term motor improvement and its influencing factors in patients with Parkinson's disease (PD) under general anesthesia.Methods:The cohort consisted of 48 PD patients accepted STN-DBS in Department of Neurosurgery, First Affiliated Hospital of Zhengzhou University from June 2021 to June 2023, including 21 patients accepted STN-DBS under general anesthesia and 27 patients accepted STN-DBS under local anesthesia. STN-DBS was performed in the CT operating room and intraoperative CT was used to confirm the electrode position. Regular program-controlled follow-up for over one year in Out-patient Clinic was applied after discharge. Operation time, complications, stimulus-related adverse events, unified Parkinson's disease rating scale (UPDRS)-Ⅲ score and UPDRS-Ⅲ improvement rate at medicine-off (Med-off) stage/DBS-on stage 1 year after operation, and UPDRS-Ⅲ score and UPDRS-Ⅲ improvement rate at medicine-on (Med-on) stage/DBS-on stage 1 year after operation, and levodopa equivalent daily dose (LEDD) and LEDD reduction were compared between the two groups. Spearman rank correlation analysis or Pearson correlation analysis were used to investigate the correlation between short-term motor improvement ([UPDRS-Ⅲ score at Med-off stage before operation-UPDRS-Ⅲ score at Med-off stage/DBS-on stage 1 year after operation]/UPDRS-Ⅲ score at Med-off stage before operation×100%) and clinical data in PD after STN-DBS under general anesthesia.Results:The operation time of general anesthesia group was (1.9±0.5) h, and that of local anesthesia group was (2.6±0.8) h, with significant difference ( P<0.05). During the 1-year follow-up, no significant difference in incidence of adverse reactions, UPDRS-Ⅲ score improvement rate at Med-on and Med-off stages, LEDD and LEDD reduction was noted between the two groups ( P>0.05). In the general anesthesia group, the short-term motor improvement after STN-DBS was negatively correlated with age or gender ( P>0.05), but positively correlated with maximum improvement rate of preoperative UPDRS-Ⅲ score ( r=0.840, P<0.001). Conclusion:For patients who cannot tolerate local anesthesia, DBS under general anesthesia is also safe and effective.
