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The relationship between the levodopa challenge test (LDCT) and postoperative subthalamic nucleus-deep brain stimulation (STN-DBS) benefits is controversial in patients with Parkinson\u2019s disease (PD). We aim to evaluate the value of total levodopa response (TLR) and symptom levodopa response (SLR) in predicting postoperative improvement in different PD motor subtypes. Methods. Studies were split into a training set (147 patients) and a validation set (304 patients). We retrospectively collected data from 147 patients who received the Unified Parkinson\u2019s Disease Rating Scale- (UPDRS-) III and the Parkinson\u2019s Disease Questionnaire- (PDQ-) 39 evaluation. Patients were classified into tremor-dominant (TD), akinetic-rigid-dominant (AR), and mixed (MX) groups. Clinically important difference (CID) was employed to dichotomize DBS effects. For patients in each subtype group from the training set, we used the correlation and receiver operator characteristic (ROC) curve analyses to explore the strength of their relations. Areas under the curve (AUCs) were calculated and compared through the DeLong test. Results developed from the training set were applied into the validation set to predict postoperative improvement in different PD motor subtypes. Results. In the validation cohort, TLR significantly correlated with postoperative motor (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                        <a:mo>&lt;<\/a:mo>\n                        <a:mn>0.001<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>) and quality of life (QOL) (<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                        <c:mo>&lt;<\/c:mo>\n                        <c:mn>0.001<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>) improvement in the MX group. The AUC between TLR and UPDRS-III (TU) is 0.800. The AUC between TLR and PDQ-39 (TP) is 0.770. An associated criterion in both TU and TP is around 50%. In the AR group, strong correlation was only found in SLR and PDQ-39 (SP) (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>p<\/e:mi>\n                        <e:mo>&lt;<\/e:mo>\n                        <e:mn>0.001<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>). And the AUC of SP is significantly larger than that in TLR and PDQ-39 (TP) (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>p<\/g:mi>\n                        <g:mo>=<\/g:mo>\n                        <g:mn>0.034<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>). An associated criterion in SP is around 37%. No significant correlation was found in the TD group. Conclusions. We provide a more accurate judgment for LDCT. TLR strongly correlated with postoperative UPDRS-III and PDQ-39 improvement in MX patients. A <jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mtext>TLR<\/i:mtext>\n                        <i:mo>&gt;<\/i:mo>\n                        <i:mn>50<\/i:mn>\n                        <i:mi>%<\/i:mi>\n                     <\/i:math>\n                  <\/jats:inline-formula> may indicate a higher possibility of clinically meaningful benefits from STN-DBS comparing to medication only. SLR can well predict QOL improvement in AR patients. Similarly, a <jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mtext>SLR<\/k:mtext>\n                        <k:mo>&gt;<\/k:mo>\n                        <k:mn>37<\/k:mn>\n                        <k:mi>%<\/k:mi>\n                     <\/k:math>\n                  <\/jats:inline-formula> may indicate a higher possibility of clinically significant benefits from STN-DBS. LDCT provides limited information for TD patients.<\/jats:p>","DOI":"10.1155\/2021\/4762027","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T19:20:18Z","timestamp":1634844018000},"page":"1-10","source":"Crossref","is-referenced-by-count":13,"title":["Levodopa Challenge Test Predicts STN-DBS Outcomes in Various Parkinson\u2019s Disease Motor Subtypes: A More Accurate Judgment"],"prefix":"10.1155","volume":"2021","author":[{"given":"Zijian","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"},{"name":"The First Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixiao","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"},{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bohan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"},{"name":"Department of Neurology, Qilu Hospital, Shandong University, Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houyou","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"},{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuancheng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"},{"name":"The First Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongwei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1248-3420","authenticated-orcid":true,"given":"Xi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Changhai Hospital of the Second Military Medical University of Chinese PLA, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6713-0000","authenticated-orcid":true,"given":"Guohui","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 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