Brain pacemaker surgery (DBS) has become an increasingly popular choice for patients due to its characteristics and superiority in treating Parkinson’s disease, but not every Parkinson’s patient is a good candidate for the procedure. What kind of patients are suitable for pacemaker surgery? What items should patients be tested before brain pacemaker surgery? 1. Levodopa shock test: How responsive patients with motor fluctuations and allodynia are to dopamine predicts the effectiveness of DBS surgery. To assess the responsiveness of dyskinesia and compound dopamine, the UPDRS-3 score is mostly used. The time of opening period is not important, but the degree of improvement of dyskinesia is more important, and the levodopa shock test is an important predictor to determine whether DBS therapy is an important one. 2. There is a direct relationship between the maximum improvement rate of levodopa and the effect of surgery: the specific method is that the subjects need to discontinue dopamine agonists for 72 hours and compounded levodopa preparations and other anti-PD drugs for 12 hours. The test drug was a compounded levodopa standard tablet, and the dose was converted to 1.5 times the equivalent dose of levodopa by the previous anti-PD drug taken for the first time each morning, and the UPDRS score was first taken as a baseline in the fasted state, followed by morpholine (domperidone tablets) 10 mg, followed by compounded levodopa standard tablets 30 min later, and then assessed every 30 min with UPDRS- 3 score until 4 hours after the administration of the drug. The maximum improvement rate of UPDRS was calculated as the pre-dose baseline score – the lowest post-dose score / pre-dose baseline score * 100%. If the improvement is >30%, it predicts a good surgical outcome for DBS, if there is no change in symptoms except tremor and motor impairment persists. the surgical outcome for DBS is poor. 3. Cognitive testing: severe cognitive impairment (dementia) is a contraindication to DBS surgery, and about 40% of patients with advanced PD have co-morbid dementia, so surgery is not recommended for patients with preoperative dementia for the time being. Assessment options are MMSE, MoCA, ADAS-Cog, Wechsler Adult Intelligence Scale, etc. 4.Psychiatric testing: Those with severe and refractory psychiatric disorders are contraindications to DBS therapy. The Hamilton Depression Scale, Hamilton Anxiety Inventory to assess mood disorders, Neuropsychiatric Inventory, and Brief Psychiatric Inventory to assess psychiatric disorders are used. 5. Other factors: Patients should preferably not be older than 75 years and have a disease duration of more than 5 years (this helps to differentiate from MSA with multiple system atrophy of the brain, PSA with progressive supranuclear palsy), but if tremor predominates in cases with poor pharmacological results, DBS surgery should be performed as early as possible (more than 3 years). 6, medication status: cases in which levodopa was once effective, no longer better for the emergence of motor fluctuations and heterokinetic drug regimen adjustments, and a clear reduction in quality of life. 7, reasonable expectations: before surgery should know that surgery does not change the course of Parkinson’s disease progression, can only improve the quality of life for a period of time in the course of the disease, there is relief for muscle tone and tremor, but not clear relief for non-motor disorder symptoms, not all patients can reduce or stop medication, surgery is generally safe and effective, improve quality of life, but there are also surgical risks. 8. Contraindications: severe cognitive impairment, severe anxiety, depression, schizophrenia, severe physical illness.