Awake Neurophysiologically Guided versus Asleep MRI-Guided STN DBS for Parkinson Disease: A Comparison of Outcomes Using Levodopa Equivalents

Stereotactic and Functional Neurosurgery
Sara SalehKarl A Sillay

Abstract

Deep brain stimulation (DBS) for Parkinson's disease (PD) has traditionally been performed in awake patients. Some patients are unable to tolerate awake surgery or extensive time off their medication to allow for neurophysiological testing during traditional DBS implantation, which has previously limited surgical options for these patients. Recently, asleep image-guided lead placement using intraoperative MRI or CT for verification has been proposed as an alternative for patients unable or unwilling to undergo awake DBS surgery. We conducted a retrospective chart review comparing PD patients who underwent asleep MRI-guided subthalamic nucleus (STN) DBS lead placement (n = 14) and awake neurophysiologically guided STN DBS lead placement (n = 23) at our institution. Both groups' levodopa equivalent daily doses (LEDDs) and complications at approximately 6 months of follow-up were compared, along with operative times. Both groups showed statistically similar reductions in LEDD at 6 months of therapy (38.27% for awake, 49.27% for asleep; p = 0.4447), and similar complications. Operative times were initially longer for MRI-guided DBS but improved with surgical experience. Asleep MRI-guided DBS is a viable option for PD patients unabl...Continue Reading

Citations

Aug 18, 2016·Frontiers in Surgery·Ramsey A FalconerMahesh B Shenai
Mar 17, 2018·Journal of Neurosurgery·Tsinsue ChenFrancisco A Ponce
Sep 19, 2017·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Veena SheshadriLashmi Venkatraghavan
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 23, 2021·Journal of Neurological Surgery. Part A, Central European Neurosurgery·Fadi AlmahariqDarko Chudy
Jul 16, 2021·Frontiers in Neurology·Francesco SammartinoVibhor Krishna
Oct 30, 2021·Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko·S V AsriyantsI N Pronin
Sep 10, 2018·Stereotactic and Functional Neurosurgery·Mahsa MalekmohammadiNader Pouratian

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