Background: Monitoring the depth of anesthesia by electroencephalogram (EEG) based on the prefrontal cortex is an important means to achieve accurate regulation of anesthesia for subthalamic nucleus (STN) deep brain stimulation (DBS) under general anesthesia in patients with Parkinson’s disease (PD). However, no previous study has conducted an in-depth investigation into this monitoring data. Here, we aimed to analyze the characteristics of prefrontal cortex EEG during DBS with propofol general anesthesia in patients with PD and determine the reference range of parameters derived from the depth of anesthesia monitoring. Additionally, we attempted to explore whether the use of benzodiazepines in the 3 days during hospitalization before surgery impacted the interpretation of the EEG parameters. Materials and Methods: We included the data of 43 patients with PD who received STN DBS treatment and SedLine monitoring during the entire course of general anesthesia with propofol in a single center. Eighteen patients (41.86%) took benzodiazepines during hospitalization. We divided the anesthesia process into three stages: awake state before anesthesia, propofol anesthesia state, and shallow anesthesia state during microelectrode recording (MER). We analyzed the power spectral density (PSD) and derived parameters of the patients’ prefrontal EEG, including the patient state index (PSI), spectral edge frequency (SEF) of the left and right sides, and the suppression ratio. The baseline characteristics, preoperative medication, preoperative frontal lobe image characteristics, preoperative motor and non-motor evaluation, intraoperative vital signs, internal environment and anesthetic information, and postoperative complications are listed. We also compared the groups according to whether they took benzodiazepines before surgery during hospitalization. Results: The average PSI of the awake state, propofol anesthesia state, and MER state were 89.86 ± 6.89, 48.68 ± 12.65, and 62.46 ± 13.08, respectively. The preoperative administration of benzodiazepines did not significantly affect the PSI or SEF, but did reduce the total time of suppression, maximum suppression ratio, and the PSD of beta and gamma during MER. Regarding the occurrence of postoperative delirium and mini-mental state examination (MMSE) scores, there was no significant difference between the two groups (chi-square test, p = 0.48; Mann–Whitney U test, p = 0.30). Conclusion: For the first time, we demonstrate the reference range of the derived parameters of the depth of anesthesia monitoring and the characteristics of the prefrontal EEG of patients with PD in the awake state, propofol anesthesia state, and shallow anesthesia during MER. Taking benzodiazepines in the 3 days during hospitalization before surgery reduces suppression and the PSD of beta and gamma during MER, but does not significantly affect the observation of anesthesiologists on the depth of anesthesia, nor affect the postoperative delirium and MMSE scores.

Background: Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective method for treating Parkinson’s disease (PD). However, safety of STN-DBS treating PD patients with cardiovascular disease (CVD) comorbidity is rarely focused and reported. The aim of this study is to investigate the efficacy and safety of STN-DBS treating PD patients with CVD comorbidity. Methods: We retrospectively included PD patients with CVD comorbidity who underwent STN-DBS under general anesthesia in our center from January 2019 to January 2021. Patient’s PD symptoms and cardiopulmonary function were evaluated by a multi-disciplinary team (MDT) before surgery. Post-operative clinical outcome and complications were collected until 1-year follow-up. Results: A total of 38 patients (26 men/12 women) of mean body mass index (BMI) 24.36 ± 3.11 kg/m2, with different CVD comorbidity were finally speculated in the study. These CVD include mainly hypertension, coronary artery disease, thoracic aortic aneurysm, heart valve replacement, pacemaker implantation, atrial fibrillation, patent foramen ovale, and so on. The mean systolic blood pressure (SBP) of 38 patients at admission day, pre-operation day, and discharge day timepoint was 135.63 ± 18.08 mmHg, 137.66 ± 12.26 mmHg, and 126.87 ± 13.36 mmHg, respectively. This showed that blood pressure was controlled well under stable and normal state. The indicators of myocardial infarction Troponin T (Tn T-T) levels at pre-operation, 1 day and 7 days after operation timepoint were 0.014 ± 0.011 ng/mL, 0.015 ± 0.011 ng/mL, and 0.014 ± 0.008 ng/mL, showing no significant fluctuation (F = 0.038, p = 0.962). STN-DBS improved PD patients’ UPDRS III scores by 51.38% (t = 12.33, p < 0.0001) at 1-year follow-up compared with pre-operative baseline. A total of 11 adverse events were recorded until 1-year follow-up. No obvious cardiovascular complications such as intracranial hematoma or clot-related events occurred within 1 year after surgery except 1 case of hematuria. Conclusions: STN-DBS under general anesthesia is safe and effective for treating PD patients with CVD comorbidity. Our clinical experience and protocol of the MDT offers comprehensive perioperative evaluation for DBS surgery and mitigates bleeding and cardiovascular-associated events in PD patients with CVD comorbidity.