Postoperative Effect Evaluation And Subtype Analysis Of Patients With Parkinson’s Disease

Parkinson’s disease is a degenerative disease of the central nervous system in the elderly,which seriously threatens the health of the elderly.The treatment of Parkinson’s disease is an eye-catching topic under the background of aging.The purpose of this paper is to investigate the effect of deep brain stimulation(DBS)on the symptoms of patients with Parkinson’s disease(PD)and analyze the subtype of patients with PD.333 PD patients accepted DBS in the Department of Neurosurgery of Ruijin Hospital,Shanghai Jiaotong University School Of Medicine from October 2016 to March 2021 were chosen in this paper.One week before the treatment,and three months,six months,and twelve months after the treatment,Gait and Falls Questionnaire(GFQ),Unified Parkinson’s Disease Rating Scale part Ⅰ(UPDRS-Ⅰ),Unified Parkinson’s Disease Rating Scale part Ⅲ(UPDRS-Ⅲ),the five-level EuroQol fivedimensional questionnaire(EQ-5D-5L),8 quality of life questionnaire for Parkinson’s disease(PDQ-8),Unified Parkinson’s Disease Rating Scale part Ⅱ(UPDRS-Ⅱ)and Unified Parkinson’s Disease Rating Scale part Ⅳ(UPDRS-Ⅳ)were performed on these patients,Levodopa equivalent daily doses(LEDD)and the total daily dose of Madopar were calculated.The improvement of the score of each scale and the dose of drug treatment before and after DBS were compared.Based on clinical manifestations of motor and non-motor symptoms in patients with Parkinson’s disease,including H-Y stage,tremor,rigidity,lack of movement,abnormal posture and gait,depression,anxiety,apathy,mental state and basic demographic data,cluster analysis was conducted on 100 patients with Parkinson’s disease before surgery.The clinical characteristic parameters of each subtype were compared,and the patients of each subtype were compared before and after operation.Compared with preoperative,the GFQ,UPDRS-Ⅰ,EQ-5D-5L,PDQ-8 and UPDRS-Ⅱ scores of the patients were not significantly improved at three months after surgery,but the UPDRS-Ⅲ and UPDRS-Ⅳ scores of the patients were significantly improved at three months after surgery;Compared with preoperative,the UPDRS-Ⅰ and EQ-5D-5L scores of the patients were not significantly improved at six months after the operation,but the GFQ,UPDRS-Ⅲ,PDQ-8,UPDRS-Ⅱ and UPDRS-Ⅳ scores of the patients were significantly improved at six months after the operation;Compared with preoperative,the GFQ,UPDRS-Ⅰ,UPDRS-Ⅲ,EQ5D-5L,PDQ-8,UPDRS-Ⅱ and UPDRS-Ⅳ scores of the patients were significantly improved at twelve months after surgery.Compared with preoperative,respectively,LEDD and the total daily dose of Madopar were not significantly reduced,significantly reduced,significantly reduced at three months,six months and twelve months after operation.A total of 100 preoperative patients with Parkinson’s disease were clustered into four subtypes:young-onset subtype in early stage,young-onset subtype in late stage,old-onset subtype in early stage,old-onset subtype in late stage.Mood symptoms,such as depression,anxiety,and apathy were milder in patients with early onset,and more severe in patients with late onset.Compared with preoperation,the improvement degrees of LEDD,UPDRS-I,UPDRS-Ⅱ and UPDRS-Ⅲscores of patients in each subgroup were different after operation.After the data statistics and analysis in this paper,we can draw the following conclusions:DBS can significantly improve the condition of patients,especially the improvement of motor symptoms.The improvement effect of non-motor symptoms was worse than that of motor symptoms.At the same time,within one year after operation,Postoperative improvement in patients was more pronounced over time.There was clinical heterogeneity in emotional status.DBS surgery had a good improvement effect on early stage patients,but it had a general improvement effect on late stage patients.Patients with Parkinson’s disease should be treated as soon as possible.