The effect of subthalamic nucleus deep brain stimulation (STN-DBS) on balance function in patients with Parkinson’s disease (PD) and the potential outcome predictive factors remains unclear. We retrospectively included 261 PD patients who underwent STN-DBS and finished the 1-month follow-up (M1) assessment in the explorative set for identifying postoperative balance change predictors, and 111 patients who finished both the M1 and 12-month follow-up (M12) assessment in the validation set for verifying the identified factors. Motor and balance improvement were evaluated through the UPDRS-III and the Berg balance scale (BBS) and pull test (PT), respectively. Candidate predictors of balance improvement included age, disease duration, motor subtypes, baseline severity of PD, cognitive status, motor and balance response to levodopa, and stimulation parameters. In the off-medication condition, STN-DBS significantly improved BBS and PT performance in both the M1 and M12, in both datasets. While in the on-medication condition, no significant balance improvement was observed. Higher preoperative BBS response to levodopa was significantly associated with larger postoperative off-medication, but not on-medication, BBS (p < 0.001) and PT (p < 0.001) improvement in both the M1 and M12. BBS subitems 8, 9, 11, 13, and 14 were the major contributors to the prediction of balance improvement after STN-DBS. STN-DBS improves short-term off-medication, but not on-medication, balance function assessed through BBS and PT. Preoperative BBS response to levodopa best predicts postoperative off-medication balance improvement. For patients who manifested severe balance problems, a levodopa challenge test on BBS or the short version of BBS is recommended.

丘脑下核深部脑刺激（STN-DBS）对帕金森病（PD）患者平衡功能的影响以及潜在的结果预测因素尚不清楚。我们回顾性地纳入了261例接受STN-DBS并完成了为期1个月的随访（M1）评估的PD患者，以鉴定术后平衡变化的预测因素，以及111例同时进行了M1和12个月的随访的患者（M12）在验证集中进行评估，以验证所识别的因素。分别通过UPDRS-III和Berg平衡量表（BBS）和拉力测试（PT）评估了运动能力和平衡能力的提高。平衡改善的候选预测因素包括年龄，疾病持续时间，运动亚型，PD的基线严重程度，认知状态，运动和对左旋多巴的平衡反应，和刺激参数。在非用药条件下，STN-DBS在两个数据集中的M1和M12中均显着改善了BBS和PT性能。在用药状态下，未观察到明显的平衡改善。术前BBS对左旋多巴的较高反应与较大的术后药物外治疗有关，但与药物治疗后BBS无关（p  <0.001）和PT（p  <0.001）在M1和M12中均得到改善。BST子项目8、9、11、13和14是STN-DBS之后预测平衡改善的主要因素。通过BBS和PT评估，STN-DBS可改善短期用药，但不能改善用药时的平衡功能。术前BBS对左旋多巴的反应最能预测术后药物外平衡的改善。对于表现出严重平衡问题的患者，建议对BBS或简短版本的BBS进行左旋多巴激发试验。