"Asleep" Deep Brain Stimulation Surgery: A Critical Review of the Literature

World Neurosurgery
Tsinsue ChenFrancisco A Ponce

Abstract

Although performing deep brain stimulation (DBS) with the patient under general anesthesia without microelectrode recording (MER) or intraoperative test stimulation (ITS) for movement disorders ("asleep" DBS) has become increasingly popular, its feasibility is based on the untested assumption that stereotactic accuracy correlates with positive clinical outcomes. To investigate outcomes after asleep DBS without MER or neurophysiological testing, we reviewed the medical literature on the topic. We searched PubMed to identify all studies reporting clinical outcomes for patients who underwent DBS without MER or ITS for Parkinson disease (PD) or essential tremor (ET). We identified 9 studies with level 3b (n = 3) or level 4 evidence (n = 6). Eight PD studies (220 patients) reported asleep placement of 431 electrodes (341 subthalamic nucleus, 90 globus pallidus interna). Unified Parkinson Disease Rating Scale motor examination-III scores for 208 patients demonstrated significant improvement (40.2%-65%) at 6-12 months. The levodopa equivalent daily dose for 115 patients was significantly reduced (14%-49.3%) at 6-12 months in 103 patients. Two studies with a comparison cohort undergoing "awake" DBS with MER found no differences in post...Continue Reading

Citations

Oct 28, 2017·Archives of Clinical Neuropsychology : the Official Journal of the National Academy of Neuropsychologists·Alexander I Tröster
Mar 17, 2018·Journal of Neurosurgery·Tsinsue ChenFrancisco A Ponce
Dec 22, 2017·Neuromodulation : Journal of the International Neuromodulation Society·Leonardo A FrizonAndre G Machado
Oct 24, 2018·Expert Review of Neurotherapeutics·Aparna Wagle ShuklaAdolfo Ramirez-Zamora
Jan 11, 2019·Neuromodulation : Journal of the International Neuromodulation Society·Naomi I KremerJ Marc C van Dijk
Dec 13, 2019·Neuromodulation : Journal of the International Neuromodulation Society·Jun WangShao-Wu Ou
Jul 15, 2020·Neuromodulation : Journal of the International Neuromodulation Society·Farhad SenemmarStefan Jun Groiss
Feb 12, 2019·The Journal of Clinical Investigation·Kelly A Mills
Feb 20, 2020·American Journal of Speech-language Pathology·Elizabeth Erickson-DiRenzoCasey H Halpern
Dec 17, 2020·Neuromodulation : Journal of the International Neuromodulation Society·Hongxia LiYiwen Wu
Feb 11, 2021·Anesthesiology Clinics·Lane CrawfordLetha Mathews
Apr 27, 2021·British Journal of Anaesthesia·Antonio Martinez-SimonManuel Alegre
Sep 30, 2021·Movement Disorders : Official Journal of the Movement Disorder Society·Leo Verhagen MetmanPepijn van den Munckhof
Oct 30, 2021·Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko·S V AsriyantsI N Pronin
Dec 6, 2018·Stereotactic and Functional Neurosurgery·Nina ZechErnil Hansen
Feb 6, 2020·Stereotactic and Functional Neurosurgery·Kim J BurchielAnn Mitchell

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