Relationship Between Electrode Position and Clinical Efficacy of Subthalamic Nucleus Deep Brain Stimulation and Motor Symptoms of Parkinson's Disease

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Abstract Objectives To investigate the relationship between the position of bilateral STN-DBS location of active contacts and clinical efficacy of STN-DBS in the motor symptoms of Parkinson’ disease (PD) patients. Methods We retrospectively analyzed the clinical data of 57 patients with PD who underwent bilateral STN-DBS from March 2018 to December 2018. UPDRS III scores, LEDD, PDQ-39 scores before operation and within 6 months after operation were determined. The location of activate contacts and volume of tissue activated (VTA) in the Montreal Neurological Institute (MNI) space, and their correlation with the rate of improvement of motor symptoms（UPDRS-Ⅲ score improvement rate）were examined. Results After 6 months of follow up, the UPDRS-Ⅲ scores of 57 patients（Med-off） were improved by 55.4±18.9% (P＜0.001) compared with that before operation. The improvement rate of PDQ-39 score [(47.4±23.2)%, (PPr=0.461, P＜0.001; LEDD:r=0.354, P=0.007)，the rate of improvement of UPDRS Ⅲ (Med-off) and the Z-axis coordinate of the active contact in the MNI space were positively correlated (left side:r=0.349,P=0.008;right eide:r=0.369,P=0.005). In the MNI space,there was no correlation between the UPDRS-Ⅲ score improvement rate (Med-off) at 6 months after operation and bilateral VTA in the STN motor subregion,STN associative subregion and STN limbic subregion of the active electrode contacts of 57 patients(all P>0.05).At 6 months after surgery, the difference between the Z-axis coordinate in the different improvement rate subgroups（＜25%, 25% to 50%, and＞50%） in the MNI space was statistically significant (left side: P=0.030; right side: P=0.024). In the MNI space, there was no statistically significant difference between the 3 groups in the VTA of the active electrode contacts (all P>0.05). Conclusions STN-DBS could improve the motor symptoms of PD patients and improved the quality of life. The closer the active stimulation contacts is to the dorsolateral sensorimotor area of STN, the better effect the DBS has on the motor symptoms of PD patients.

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