Construction and prediction value of model of deep brain stimulation for improvement of sleep state in patients with Parkinson's disease
Objective To analyze the influencing factors of sleep disorder improvement in patients with Parkinson's disease(PD)1 year after deep brain stimulation(DBS),and to construct a nomogram model that can effectively predict the improvement of patients'sleep quality after surgery.Methods A retrospective analysis was performed on the clinical data and questionnaire survey results of 333 PD patients who received DBS(STN-DBS)targeting the subthalamic nucleus(STN)at the Neurosurgery Department of the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital)from January 2020 to August 2022.According to whether the PD Sleep Scale(PDSS)score improved 1 year after surgery,333 patients were divided into a sleep disorder improvement group and a non-improvement group.Univariate and multivariate logistic regression analyses were used to screen factors affecting the improvement of patients'sleep disorders 1 year after surgery,and a nomogram model was established to predict the improvement of patients'sleep disorders.Receiver operating characteristic(ROC)curve and decision curve analysis(DCA)were used to evaluate the discrimination and fitting performance of the prediction model.Results Compared with the patients in the group whose sleep disorder did not improve after surgery,the patients in the group whose sleep disorder improved had better preoperative drug improvement rate,Mini-Mental State Examination(MMSE)score,and Hamilton Anxiety Rating Scale(HAMA)score,while they had worse PDSS score(all P＜0.05).Further univariate and multivariate logistic regression analyses showed that the improvement rate of preoperative medication(OR=0.00,95％CI:0.00-0.00,P=0.002),preoperative MMSE score(OR=0.78,95％CI:0.71-0.86,P＜0.001),preoperative HAMA score(OR=1.15,95％CI:1.06-1.25,P=0.001)and preoperative PDSS score(OR=1.03,95％CI:1.00-1.06,P=0.004)were independent risk factors for postoperative sleep disorder improvement in PD patients.A nomogram model was established based on independent risk factors,and the area under the ROC curve was 0.78(95％CI:0.69-0.88);the DCA results showed good fit between the predicted values of the nomogram and the actual observed values.Conclusion The nomogram model established in this study has certain value in predicting the improvement of sleep quality in PD patients 1 year after STN-DBS surgery.
Parkinson diseaseDeep brain stimulationSleep disordersNomogramPre-diction model
万方数据
维普
