Expectations and Level of Satisfaction of the Patient with Parkinson’s Disease Undergoing Deep Brain Stimulation Surgery at the National Institute of Neurology and Neurosurgery

Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.

Sex modulates the outcome of subthalamic nucleus deep brain stimulation in patients with Parkinson's disease

There are many documented sex differences in the clinical course,symptom expression profile,and treatment response of Parkinson’s disease,creating additional challenges for patient management.Although subthalamic nucleus deep brain stimulation is an established therapy for Parkinson’s disease,the effects of sex on treatment outcome are still unclear.The aim of this retrospective observational study,was to examine sex differences in motor symptoms,nonmotor symptoms,and quality of life after subthalamic nucleus deep brain stimulation.Outcome measures were evaluated at 1 and 12 months post-operation in 90 patients with Parkinson’s disease undergoing subthalamic nucleus deep brain stimulation aged 63.00±8.01 years(55 men and 35 women).Outcomes of clinical evaluations were compared between sexes via a Student’s t-test and within sex via a paired-sample t-test,and generalized linear models were established to identify factors associated with treatment efficacy and intensity for each sex.We found that subthalamic nucleus deep brain stimulation could improve motor symptoms in men but not women in the on-medication condition at 1 and 12 months post-operation.Restless legs syndrome was alleviated to a greater extent in men than in women.Women demonstrated poorer quality of life at baseline and achieved less improvement of quality of life than men after subthalamic nucleus deep brain stimulation.Furthermore,Hoehn-Yahr stage was positively correlated with the treatment response in men,while levodopa equivalent dose at 12 months post-operation was negatively correlated with motor improvement in women.In conclusion,women received less benefit from subthalamic nucleus deep brain stimulation than men in terms of motor symptoms,non-motor symptoms,and quality of life.We found sex-specific factors,i.e.,Hoehn-Yahr stage and levodopa equivalent dose,that were related to motor improvements.These findings may help to guide subthalamic nucleus deep brain stimulation patient selection,prognosis,and stimulation programming for optimal therapeutic efficacy in Parkinson’s disease.

The Application of Deep Brain Stimulation for Parkinson’s Disease on the Motor Pathway:A Bibliometric Analysis across 10 Years

Background and Objective Since its initial report by James Parkinson in 1817,Parkinson’s disease(PD)has remained a central subject of research and clinical advancement.The disease is estimated to affect approximately 1%of adults aged 60 and above.Deep brain stimulation,emerging as an alternative therapy for end-stage cases,has offered a lifeline to numerous patients.This review aimed to analyze publications pertaining to the impact of deep brain stimulation on the motor pathway in patients with PD over the last decade.Methods Data were obtained from the Web of Science Core Collection through the library of Huazhong University of Science and Technology(China).The search strategy encompassed the following keywords:“deep brain stimulation”,“Parkinson’s disease”,“motor pathway”,and“human”,from January 1,2012,to December 1,2022.Additionally,this review visualized the findings using the Citespace software.Results The results indicated that the United States,the United Kingdom,Germany,and China were the primary contributors to this research field.University College London,Capital Medical University,and Maastricht University were the top 3 research institutions in the research area.Tom Foltynie ranked first with 6 publications,and the journals of Brain and Brain Stimulation published the greatest number of relevant articles.The prevailing research focal points in this domain,as determined by keywords“burst analysis”,“encompassed neuronal activity”,“nucleus”,“hyper direct pathway”,etc.Conclusion This study has provided a new perspective through bibliometric analysis of the deep brain stimulation therapy for treating patients with PD,which can shed light on future research to advance our comprehension of this particular field of study.

Research progress in the efficacy of deep brain stimulation with different targets in Parkinson's disease

Parkinson's disease(PD)is a chronic progressive neurodegenerative disease.Deep brain stimulation(DBS)is an effective treatment for patients with advanced PD.There are many DBS targets for PD,including subthalamic nucleus(STN),globus pallidus(GPi),meso-ventral thalamic nucleus(VIM),pontine peduncle nucleus(PPN),posterior subthalamic region(PSA)and zonation of undetermined zone(ZI).This paper summarizes the efficacy of each target in the treatment of PD with DBS,not only makes a systematic analysis and comparison of motor symptoms,but also makes a detailed description of the efficacy of non-motor symptoms,so as to provide a personalized treatment basis for PD patients to select appropriate target targets in DBS.

Towards frequency adaptation for delayed feedback deep brain stimulations

In neurodegenerative disorders such as Parkinson＇s disease （PD）, deep brain stimulation （DBS） is a desirable approach when the medication is less effective for treating the symptoms. DBS incorporates transferring electrical pulses to a specific tissue of the central nervous system, obtaining therapeutic results by modulating the neuronal activity of that region. DBS has certain advantages such as reversibility and adjustability features over medication, since the neuronal firing patterns can be recorded and used to alter the parameters of the DBS signal （Benabid et al., 2009）. One of the DBS indications is its ability to suppress the abnormal neuronal activity to treat symptoms like tremor, akinesia and dystonia.

局部麻醉与全身麻醉下行STN-DBS治疗帕金森病临床效果对比观察

目的对比观察局部麻醉与全身麻醉下行丘脑底核脑深部电刺激术(STN-DBS)治疗帕金森病的临床效果。方法选择帕金森病患者63例,在局部麻醉下行STN-DBS治疗30例(局麻组)、在全身麻醉下行STN-DBS治疗33例(全麻组)。治疗前与治疗后3个月,采用统一帕金森病评定量表Ⅲ(UPDRS-Ⅲ)评分评估运动功能。术中微电极记录STN放电频率;根据放电活动判断STN与微电极的相对位置,计算定位记录长度;术后接受磁共振成像检查,探查计划位置坐标与电极实际植入位置,计算坐标误差。治疗前与治疗后3个月,采用蒙特利尔认知评估量表(MoCA)评分评估认知功能,测量立位与卧位血压、搏动指数(PI)、大脑中动脉平均流速(Vm),计算立位与卧位平均动脉压差值(ΔMAP)、PI差值(ΔPI)、Vm差值(ΔVm)。记录围手术期麻醉、刺激、硬件相关并发症。结果两组治疗后开期和关期UPDRS-Ⅲ评分均低于治疗前(P均<0.05),两组治疗后开期和关期UPDRS-Ⅲ评分比较差异均无统计学意义(P均>0.05)。全麻组STN放电频率、定位记录长度均低于局麻组(P均<0.05),而两组坐标误差比较差异无统计学意义(P>0.05)。两组治疗后MoCA各维度评分均高于治疗前(P均<0.05),两组治疗后MoCA各维度评分比较差异均无统计学意义(P均>0.05)。局麻组治疗后ΔMAP、ΔPI、ΔVm均低于治疗前(P均<0.05),全麻组治疗前后ΔMAP、ΔPI、ΔVm比较差异均无统计学意义(P均>0.05);全麻组治疗后ΔMAP、ΔPI、ΔVm均高于局麻组治疗后(P均<0.05)。局麻组手术当日出现脑出血2例,经保守治疗后好转,两组均未发生其他麻醉、刺激、硬件相关并发症。结论全身麻醉与局部麻醉下行STN-DBS对于改善帕金森病患者运动功能和认知功能的临床效果相当,但全身麻醉下脑血流自动调节功能稳定,有利于准确定位靶点。

Millimetric devices for nerve stimulation:a promising path towards miniaturization

Nerve stimulation is a rapidly developing field,demonstrating positive outcomes across several conditions.Despite potential benefits,current nerve stimulation devices are large,complicated,and are powered via implanted pulse generators.These facto rs necessitate invasive surgical implantation and limit potential applications.Reducing nerve stimulation devices to millimetric sizes would make these interventions less invasive and facilitate broader therapeutic applications.However,device miniaturization presents a serious engineering challenge.This review presents significant advancements from several groups that have overcome this challenge and developed millimetricsized nerve stimulation devices.These are based on antennas,mini-coils,magneto-electric and optoelectronic materials,or receive ultrasound power.We highlight key design elements,findings from pilot studies,and present several considerations for future applications of these devices.

Partial improvement in performance of patients with severe Alzheimer's disease at an early stage of fornix deep brain stimulation

Deep brain stimulation is a therapy for Alzheimer＇s disease（AD） that has previously been used for mainly mild to moderate cases. This study provides the first evidence of early alterations in performance induced by stimulation targeted at the fornix in severe AD patients. The performance of the five cases enrolled in this study was scored with specialized assessments including the Mini-Mental State Examination and Clinical Dementia Rating, both before and at an early stage after deep brain stimulation. The burden of caregivers was also evaluated using the Zarit Caregiver Burden Interview. As a whole, the cognitive performance of patients remained stable or improved to varying degrees, and caregiver burden was decreased. Individually, an improved mental state or social performance was observed in three patients, and one of these three patients showed remarkable improvement in long-term memory. The conditions of another patient deteriorated because of inappropriate antipsychotic medications that were administered by his caregivers. Taken together, deep brain stimulation was capable of improving some cognitive aspects in patients with severe AD, and of ameliorating their emotional and social performance, at least at an early stage. However, long-term effects induced by deep brain stimulation in patients with severe AD need to be further validated. More research should focus on clarifying the mechanism of deep brain stimulation. This study was registered with ClinicalTrials.gov（NCT03115814） on April 14, 2017.

Deep Brain Stimulation──A new treatment for tinnitus

Intractable tinnitus can lead to serious consequences. Study evidence indicates that the central nervous system is involved in generation and maintenance of chronic tinnitus and that tinnitus and other neurologic symptoms such as chronic pain may share similar mechanisms. Brain ablation and stimulation are used to treat chronic pain with success. Recent studies showed that ablation and stimulation in non-auditory areas resulted in tinnitus improvement. Deep brain stimulation (DBS) may be an alternative treatment for intractable tinnitus and deserves further study.

The treatment of Parkinson's disease with deep brain stimulation: current issues

Deep brain stimulation has become a well-established symptomatic treatment for Parkinson＇s disease during the last 25 years. Besides improving motor symptoms and long-term motor complications, positive effects on patients＇ mobility, activities of daily living, emotional well-being and health-related quality of life have been recognized. Apart from that, numerous clinical trials analyzed effects on non-motor symptoms and side effects of deep brain stimulation. Several technical issues and stimulation paradigms have been and are still being developed to optimize the therapeutic effects, minimize the side effects and facilitate handling. This review summarizes current therapeutic issues, i.e., patient and target selection, surgical procedure and programming paradigms. In addition it focuses on neuropsychological effects and side effects of deep brain stimulation.

Implementation of a Smartphone as a Wearable and Wireless Accelerometer and Gyroscope Platform for Ascertaining Deep Brain Stimulation Treatment Efficacy of Parkinson’s Disease through Machine Learning Classification

Parkinson’s disease manifests in movement disorder symptoms, such as hand tremor. There exists an assortment of therapy interventions. In particular deep brain stimulation offers considerable efficacy for the treatment of Parkinson’s disease. However, a considerable challenge is the convergence toward an optimal configuration of tuning parameters. Quantified feedback from a wearable and wireless system consisting of an accelerometer and gyroscope can be enabled through a novel software application on a smartphone. The smartphone with its internal accelerometer and gyroscope can record the quantified attributes of Parkinson’s disease and tremor through mounting the smartphone about the dorsum of the hand. The recorded data can be then wirelessly transmitted as an email attachment to an Internet derived resource for subsequent post-processing. The inertial sensor data can be consolidated into a feature set for machine learning classification. A multilayer perceptron neural network has been successfully applied to attain considerable classification accuracy between deep brain stimulation “On” and “Off” scenarios for a subject with Parkinson’s disease. The findings establish the foundation for the broad objective of applying wearable and wireless systems for the development of closed-loop optimization of deep brain stimulation parameters in the context of cloud computing with machine learning classification.

Chronic deep brain stimulation of the subthalamic nucleus in a monkey model of hemiparkinsonian Dynamic alterations of extracellular fluid dopamine levels in corpus striatum

BACKGROUND： Although experimental studies have utilized high-frequency stimulation in animal models, few reports have focused on long-term subthalamic nucleus deep brain stimulation （STN DBS） in Parkinson＇s disease （PD） animal models. OBJECTIVE： The present study simulated long-term DBS system and utilized microdialysis technology to study the influence of STN DBS on levels of extracellular dopamine （DA） and its metabolites, homovanillic acid （HVA） and dihydroxy phenyl acetic acid, in the corpus striatum of a hemiparkinsonian monkey model. DESIGN, TIME AND SETTING： A controlled animal study was performed at the Neurosurgery Laboratory, Changhai Hospital of the Second Military Medical University of Chinese PLA between January 2004 and December 2007. MATERIALS： 1-methy-4-phenyl-1, 2, 3, 6-tetrahydropyrindinewas （MPTP） purchased from Sigma, USA. Type-3389 DBS electrode and type-7246 pulse generator were provided by Medtronic, USA. METHODS： Hemiparkinsonism was induced in 2 male, adult Rhesus Macaque monkeys through unilateral internal carotid artery infusion of MPTP. Following model establishment, stimulation electrodes were implanted in the right STN, and chronic high-frequency stimulation （60 μs pulse width, 130 Hz frequency, and 1.5 2.0 V pressure） was performed. MAIN OUTCOME MEASURES： Prior to, and 2 hours, 8 hours, 1 week, 1 month, and 2 months after DBS, samples were collected from the caudate nucleus and putamen using microdialysis technology Extracellular levels of DA and its metabolites were measured using high-performance liquid chromatography and electrochemical detection （HPLC-ECD） methods. RESULTS： At 8 hours, 1 week, 1 month, and 2 months after DBS, DA levels in the putamen and caudate nucleus were increased on the electrode-implanted side by 39%, 91%, 111%, and 114% and 31%, 91%, 106%, and 102%, respectively. The DA turnover rate （HVA/DA） was increased in the putamen and caudate nucleus by 186% and 91%, respectively, at 8 hours after DBS, while there was no significant difference at 1 week, 1 month, and 2 months after DBS. CONCLUSION： Effective, chronic, high frequency DBS increased extracellular DA levels in the corpus striatum, which could be one of mechanisms involved in the effects of STN DBS.

Voltage adjustment improves rigidity and tremor in Parkinson's disease patients receiving deep brain stimulation

Deep brain stimulation of the subthalamic nucleus is recognized as the most effective treatment for moderate and advanced Parkinson＇s disease. Programming of the stimulation parameters is important for maintaining the efficacy of deep brain stimulation. Voltage is consid- ered to be the most effective programming parameter. The present study is a retrospective analysis of six patients with Parkinson＇s disease （four men and two women, aged 37-65 years）, who underwent bilateral deep brain stimulation of the subthalamic nucleus at the First Affiliated Hospital of Sun Yat-sen University, China, and who subsequently adjusted only the stimulation voltage. We evaluated motor symptom severity using the Unified Parkinson＇s Disease Rating Scale Part III, symptom progression using the Hoehn and Yahr scale, and the levodopa equivalent daily dose, before surgery and 1 and 2 years after surgery. The 2-year follow-up results show that rigidity and tremor improved, and clinical symptoms were reduced, while pulse width was maintained at 60 ps and frequency at 130 Hz. Voltage adjust- ment alone is particularly suitable for patients who cannot tolerate multiparameter program adjustment. Levodopa equivalent daily dose was markedly reduced 1 and 2 years after surgery compared with baseline. Our results confirm that rigidity, tremor and bradykinesia can be best alleviated by voltage adjustment. The trial was registered at ClinicalTrials.gov （identifier： NCT01934881）.

Vascular changes caused by deep brain stimulation using double-dose gadolinium-enhanced brain MRI

We retrospectively analyzed the clinical data of 32 patients with medically intractable idiopathic Parkinson＇s disease who had undergone staged bilateral deep brain stimulation of the subtha-lamic nuclei from January 2007 to May 2011. The vascularture of the patients who received two deep brain stimulations was detected using double-dose gadolinium-enhanced brain MRI. The dimensions of straight sinus, superior sagittal sinus, ipsilateral internal cerebral vein in the tha- lamic branch and ipsilateral anterior caudate vein were reduced. These findings demonstrate that bilateral deep brain stimulation of the subthalamic nuclei affects cerebral venous blood flow.

A review of computational modeling and deep brain stimulation:applications to Parkinson’s disease

Biophysical computational models are complementary to experiments and theories,providing powerful tools for the study of neurological diseases.The focus of this review is the dynamic modeling and control strategies of Parkinson’s disease(PD).In previous studies,the development of parkinsonian network dynamics modeling has made great progress.Modeling mainly focuses on the cortex-thalamus-basal ganglia(CTBG)circuit and its sub-circuits,which helps to explore the dynamic behavior of the parkinsonian network,such as synchronization.Deep brain stimulation(DBS)is an effective strategy for the treatment of PD.At present,many studies are based on the side effects of the DBS.However,the translation from modeling results to clinical disease mitigation therapy still faces huge challenges.Here,we introduce the progress of DBS improvement.Its specific purpose is to develop novel DBS treatment methods,optimize the treatment effect of DBS for each patient,and focus on the study in closed-loop DBS.Our goal is to review the inspiration and insights gained by combining the system theory with these computational models to analyze neurodynamics and optimize DBS treatment.

Nursing, Psychological Intervention and Self-Management after Deep Brain Stimulation in Parkinson’s Disease

Parkinson’s disease (PD) is a neurodegenerative disease mainly caused by motor disorders, mostly occurring in middle-aged and elderly people. The incidence of PD has been increasing year by year, and up to now, PD is still an incurable disease. However, more and more data show that early implementation of deep brain stimulation and early medical, psychological, social and other interventions can significantly improve the quality of life and prolong the survival time of patients with Parkinson’s disease (PD). Mental health guidance, cognitive behavioral intervention, psychogenic therapy and scientific nursing for PD patients may improve the functional recovery after Deep Brain Stimulation (DBS) for Parkinson’s disease. This paper discusses the nursing and psychological intervention methods of deep brain stimulation (DBS) implantation in patients with Parkinson’s disease (PD), aiming to scientifically discuss the clinical effect of nursing psychological intervention and improve the quality of life in patients with Parkinson’s disease. Basic nursing and psychological cognitive behavior intervention measures for PD patients can improve the daily activity ability of PD patients, improve the outcome of PD patients, and effectively improve the satisfaction of PD patients with nursing work, which has certain clinical promotion significance.

Cholinergic input from the pedunculopontine nucleus to the cerebellum: implications for deep brain stimulation in Parkinson's disease

Deep brain stimulation（DBS）is a well established electrophysiological treatment initially applied to treat medication-refractory motor symptoms in Parkinson＇s disease（PD）,and is now being explored for several neurological and psychiatric disorders.The specific physiological mechanisms underlying the effectiveness of DBS are not fully understood.

Preliminary Network Centric Therapy for Machine Learning Classification of Deep Brain Stimulation Status for the Treatment of Parkinson’s Disease with a Conformal Wearable and Wireless Inertial Sensor

The concept of Network Centric Therapy represents an amalgamation of wearable and wireless inertial sensor systems and machine learning with access to a Cloud computing environment. The advent of Network Centric Therapy is highly relevant to the treatment of Parkinson’s disease through deep brain stimulation. Originally wearable and wireless systems for quantifying Parkinson’s disease involved the use a smartphone to quantify hand tremor. Although originally novel, the smartphone has notable issues as a wearable application for quantifying movement disorder tremor. The smartphone has evolved in a pathway that has made the smartphone progressively more cumbersome to mount about the dorsum of the hand. Furthermore, the smartphone utilizes an inertial sensor package that is not certified for medical analysis, and the trial data access a provisional Cloud computing environment through an email account. These concerns are resolved with the recent development of a conformal wearable and wireless inertial sensor system. This conformal wearable and wireless system mounts to the hand with the profile of a bandage by adhesive and accesses a secure Cloud computing environment through a segmented wireless connectivity strategy involving a smartphone and tablet. Additionally, the conformal wearable and wireless system is certified by the FDA of the United States of America for ascertaining medical grade inertial sensor data. These characteristics make the conformal wearable and wireless system uniquely suited for the quantification of Parkinson’s disease treatment through deep brain stimulation. Preliminary evaluation of the conformal wearable and wireless system is demonstrated through the differentiation of deep brain stimulation set to “On” and “Off” status. Based on the robustness of the acceleration signal, this signal was selected to quantify hand tremor for the prescribed deep brain stimulation settings. Machine learning classification using the Waikato Environment for Knowledge Analysis (WEKA) was applied using the multilayer perceptron neural network. The multilayer perceptron neural network achieved considerable classification accuracy for distinguishing between the deep brain stimulation system set to “On” and “Off” status through the quantified acceleration signal data obtained by this recently developed conformal wearable and wireless system. The research achievement establishes a progressive pathway to the future objective of achieving deep brain stimulation capabilities that promote closed-loop acquisition of configuration parameters that are uniquely optimized to the individual through extrinsic means of a highly conformal wearable and wireless inertial sensor system and machine learning with access to Cloud computing resources.

Application of Preoperative CT/MRI Image Fusion in Target Positioning for Deep Brain Stimulation

Objective To explore the efficacy of target positioning by preoperative CT/MRI image fusion technique in deep brain stimulation.Methods We retrospectively analyzed the clinical data and images of 79 cases(68 with Parkinson's disease,11 with dystonia) who received preoperative CT/MRI image fusion in target positioning of subthalamic nucleus in deep brain stimulation.Deviation of implanted electrodes from the target nucleus of each patient were measured.Neurological evaluations of each patient before and after the treatment were performed and compared.Complications of the positioning and treatment were recorded.Results The mean deviations of the electrodes implanted on X,Y,and Z axis were 0.5 mm,0.6 mm,and 0.6 mm,respectively.Postoperative neurologic evaluations scores of unified Parkinson's disease rating scale(UPDRS) for Parkinson's disease and Burke-Fahn-Marsden Dystonia Rating Scale(BFMDRS) for dystonia patients improved significantly compared to the preoperative scores(P<0.001); Complications occurred in 10.1%(8/79) patients,and main side effects were dysarthria and diplopia.Conclusion Target positioning by preoperative CT/MRI image fusion technique in deep brain stimulation has high accuracy and good clinical outcomes.

Deep brain stimulation of the subthalamic nucleus treats Parkinson's disease through enhancing metabolic activity of the corpus striatum Verification by single photon emission computed tomography and positron emission tomography

BACKGROUND： Subthalamic nucleus deep brain stimulation （STN DBS） for Parkinson＇s disease （PD） has achieved good effects, but to date the mechanism of STN DBS remains poorly understood STN DBS may increase dopamine levels or metabolic activity of the corpus striatum. OBJECTIVE： To validate the effects of STN DBS on dopamine metabolism and glucose metabolism in the corpus striatum of hemiparkinsonian monkeys using single photon emission computed tomography （SPECT） and position emission tomography （PET）. DESIGN, TIME AND SET＇rING： A controlled animal study was performed at the Neurosurgery Laboratory, Changhai Hospital of the Second Military Medical University of Chinese PLA between January 2004 and December 2007. METHODS： Hemiparkinsonism was induced in adult Rhesus Macaque monkeys, which exhibit similar characteristics of PD in humans, through unilateral internal carotid artery infusion of 1-methy-4-phenyl-1, 2, 3, 6-tetrahydropyrindine. Following model establishment, stimulation electrodes were implanted in the right STN, and chronic high-frequency stimulation （60 μs pulse width, 130 Hz frequency, and 1.5-2.0 V pressure） was performed. MAIN OUTCOME MEASURES： The changes in dopamine transporter （DAT）, D2 receptor （D2R）, and glucose metabolism in the corpus striatum following STN DBS were observed using SPECT and PET. RESULTS： SPECT examination showed that DAT specific binding in the right corpus striatum was increased at 3 months after DBS compared with prior to stimulation, and D2R specific binding in the right corpus striatum gradually decreased near levels on the left （non-electrode-implanted） side within 3 months after DBS. PET examination showed that the glucose metabolism in the right corpus striatum was markedly increased at 3 months after effective DBS. Hemiparkinsonism monkeys showed improved left limb rigidity, increased activities, and stable gait under chronic high-frequency stimulation. CONCLUSION： STN DBS increased striatal DAT, decreased D2R, and enhanced glucose metabolism, suggesting that chronic, high-frequency STN stimulation enhanced the metabolic activity of the corpus striatum, a mechanism for improving the PD symptoms of hemiparkinsonian monkeys.