Current status of deep brain stimulation for Parkinson’s disease in Germany

During the year of working and studying as a visiting physician at the Department of Neurosurgery, Hannover Medical School, Germany, I applied many of the world’s newest technologies and was exposed to the use of deep brain stimulation for the treatment of Parkinson’s disease. Our country is gradually entering an aging society, and the number of Parkinson’s patients continues to increase every year, which is a large group of people who need to be cared for. Deep brain stimulation technology was first applied in western developed countries, and now it has been nearly 20 years, and this technology is constantly being improved. Here, I would like to introduce to you the development of deep brain stimulation for Parkinson’s disease in Germany, based on my personal experience working in Germany. Germany is also a country with a prominent aging population and more patients with Parkinson’s disease. In Germany, the patient to see the doctor is generally the first to find a family doctor, if a Parkinson’s disease patients, just appeared uncomfortable, he will first look for the family doctor for help, the family doctor diagnosed the condition, if the condition is relatively simple, the family doctor prescribed to the patient to take medication; or the more complex will be referred to the neurological specialists to consult there. After a period of internal medicine treatment, patients with drug tolerance will be referred to a neurosurgeon for some counseling on surgical treatment. Patients are screened according to the guidelines for the treatment of Parkinson’s disease with DBS published by the European Society for Functional Neurosurgery. Their content basically corresponds to the international indications for surgery. We know that DBS surgery is relatively expensive, and since Germany is a high welfare state, health insurance covers the cost of surgical treatment of Parkinson’s disease. Moreover, DBS is really effective in treating Parkinson’s disease, so patients who are suitable for surgery are usually treated with surgery. Therefore, the number of DBS treatment for Parkinson’s disease in Germany is large, and there are many units that carry out the procedure, generally general hospitals or specialized hospitals in medium-sized cities can carry out this procedure. The electrodes, stimulators and other instruments and equipment used by the German doctors are all from Medtronic. Therefore, the method of surgery is basically the same, only in some details have different treatment, style is a little different. Germany is a very serious and grave people, and one thing has to be confirmed over and over again. For example, the determination of the target point on the imaging is determined by a number of different methods; the surgical evaluation of the effect is also very strict and meticulous, the surgery is not at all hasty. During the time I returned to China to work, the spirit of rigor, realism and pursuit of perfection permeated my work. In terms of basic research and clinical innovation in neuromodulation, the Germans are far ahead of our country. Many functional neurosurgery centers have their own laboratories. Moreover, the conditions and hardware of the laboratories are world-class, and there are more researchers, who have invested a lot in basic research. In addition, in Germany, doctors have more conditions for innovation, which means that German doctors do not have as many scruples as Chinese doctors in performing some new surgeries and expanding new types of diseases. Therefore, Germany does better than China in performing new surgeries, but there is no difference in a proven technique like DBS for Parkinson’s disease.