Preliminary study of the treatment of brain diseases by remote manipulation of deep brain stimulation with 5G communication

Objective To verify the feasibility of remote manipulation of deep brain stimulation (DBS) with 5G communication for the treatment of brain diseases. Methods In March 2019, 3 patients(2 parkinson′s disease and 1 essential tremor) who planned to undergo DBS at Department of Neurosurgery, the First Medical Center of the PLA General Hospital were prospectively recruited into this study. The 5G communication links were established between Beijing and Sanya, Hainan (Hainan Hospital of PLA Gerenal Hospital). The operation group completed the steps such as installation of head frame, craniotomy, microelectrode puncture for the patients in the operation room in Beijing. The remote-control group completed the steps such as remote surgery planning, remote control of microelectrode recording (MER), and imaging results confirmation of electrode implantation. Results During remote surgical procedures under 5G communication, the maximum downlink peak rate was 119 Mbps, the uplink peak rate was 27 Mbs, and the average delay was 76 ms. During the operation, the remote control of the MER drive system ran smoothly and there was no delay of signal transmission. The voice and picture of the operating room and the MER signal were transmitted smoothly. The operation was completed successfully. There were no complications such as puncture bleeding, infection and skin ulceration after the operation. At 3-month follow-up, based on clinical rating scale for tremor (CRST) the score of essential tremor patient was improved by 43.6%; the UPDRS (unified Parkinson disease rating scale)-Ⅲ scores of 2 Parkinson′s disease patients were improved by 84.9% and 90.5% respectively. Conclusion The remote control of MER in DBS surgery with 5G communication seems to have certain feasibility. Key words: Parkinson disease; Essential tremor; Deep brain stimulation; 5G communication; Remote control surgery