CNRClinical Neuroscience Research3083-48992981-8133Bio-Byword Scientific Publishing Pty. Ltd.10.26689/cnr.v4i2.15379ArticleSubthalamic Nucleus Subdivision‑Targeted DBS for Brainstem Neural Remodeling and Long‑Term Rehabilitation Follow‑up in Parkinson’s Disease with Refractory Dysphagiahttps://artdesignp.com/journal/CNR/4/2/10.26689/cnr.v4i2.15379ZhuYuefeng2026422026-06-30Objective: To investigate the differential efficacy of deep brain stimulation (DBS) targeting distinct subthalamic nucleus (STN) subdivisions on Parkinson’s disease (PD) patients with refractory dysphagia, and to elucidate the potential remodeling mechanisms of brainstem swallowing-related nuclei. Methods: Seventy-six PD patients with dysphagia admitted between March 2020 and March 2023 were enrolled and randomly assigned to the sensorimotor subdivision group (n=38) or the limbic-associative subdivision group (n=38). Swallowing function was assessed preoperatively and at 12 and 24 months postoperatively using videofluoroscopic swallowing study (VFSS), high-resolution manometry, and the Penetration-Aspiration Scale (PAS). Tongue pressure and superior laryngeal nerve evoked potentials were also recorded. Results: At 24 months postoperatively, the PAS score in the sensorimotor group decreased from 5.89±1.12 preoperatively to 2.34±0.78 (P<0.01), which was significantly better than that in the limbic-associative group (4.12±0.95). VFSS revealed a 42.3% increase in laryngeal elevation amplitude and a 38.6% reduction in pharyngeal transit time following sensorimotor subdivision stimulation. Evoked potentials showed a 29.4% shortening of latency in the nucleus tractus solitarius, indicating enhanced excitability of brainstem swallowing interneurons. Conclusion: Precise targeting of the STN sensorimotor subdivision via DBS achieves long-term swallowing function remodeling by upregulating brainstem swallowing center excitability, offering a novel surgical strategy for PD-related dysphagia.

Yu H, Quaynor SD, Takahashi K, et al., 2020, Effect of Deep Brain Stimulation on Swallowing Function: A Systematic Review. Frontiers in Neurology, 2020(11): 547.

Pitts LL, Morales S, Stierwalt JAG, et al., 2018, Lingual Pressure as a Clinical Indicator of Swallowing Function in Parkinson’s Disease. Journal of Speech, Language, and Hearing Research, 61(2): 257–265.

Suttrup I, Warnecke T, 2016, Dysphagia in Parkinson’s Disease. Dysphagia, 31(1): 24–32.

Huang P, Gong W, 2025, Concerns Regarding GPi DBS and Mild Dysphagia in Parkinson’s Disease. Dysphagia, 2025(40): 1022.

Allert N, Mückenhoff M, Stiasny-Kolster K, et al., 2011, Role of Dysphagia in Evaluating Parkinson Patients for Subthalamic Nucleus Stimulation: A Case Report. Journal of Neural Transmission, 118(9): 1345–1348.

Xie T, Yu H, Quaynor SD, et al., 2020, Effect of Deep Brain Stimulation on Swallowing Function: A Systematic Review. Frontiers in Neurology, 2020(11): 547.

Lopiano L, Modugno N, Marano M, et al., 2022, STN-DBS Does Not Increase the Risk of Sialorrhea in Patients with Advanced Parkinson’s Disease. NPJ Parkinson’s Disease, 2022(8): 85.

Chinese Society of Parkinson’s Disease and Movement Disorders, Neurology Branch of Chinese Medical Association, 2024, Chinese Expert Consensus on Dysphagia Rehabilitation in Parkinson’s Disease Patients (2024 edition). Chinese Journal of Neurology, 46(7): 587–592.

Zhao JY, 2015, Regulatory Effect of Acupuncture at Ren and Du Meridians on Brainstem Swallowing Interneurons, thesis, Guangzhou University of Chinese Medicine.

Smith-Hublou M, Herndon N, Wong JK, et al., 2024, GPi DBS and Swallowing Function in Parkinson’s Disease. Dysphagia, 39(5): 797–807.