Clinical Study of Intraoperative Microelectrode Recordings during Awake and Asleep Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease: A Retrospective Cohort Study

• Published in: Brain sciences Vol. 12; no. 11; p. 1469
• Main Authors: Zhao, Guang-Rui, Cheng, Yi-Feng, Feng, Ke-Ke, Wang, Min, Wang, Yan-Gang, Wu, Yu-Zhang, Yin, Shao-Ya
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 29-10-2022; MDPI
• Subjects: Anesthesia; Cognitive ability; Cohort analysis; Deep brain stimulation; deep brain stimulation (DBS); Electrical stimuli; Electrodes; general anesthesia (GA); local anesthesia (LA); Magnetic resonance imaging; microelectrode recording (MER); Movement disorders; Neurodegenerative diseases; Normal distribution; Parkinson's disease; Parkinson’s disease (PD); Quality of life; Solitary tract nucleus; Statistical analysis; Subthalamic nucleus; subthalamic nucleus (STN); Surgery; subthalamic nucleus (STN); awake DBS; asleep DBS; general anesthesia (GA); local anesthesia (LA); Parkinson’s disease (PD); microelectrode recording (MER); deep brain stimulation (DBS)
• ISSN: 2076-3425; 2076-3425
• DOI: 10.3390/brainsci12111469

Our objective is to analyze the difference of microelectrode recording (MER) during awake and asleep subthalamic nucleus deep brain stimulation (STN-DBS) for Parkinson’s disease (PD) and the necessity of MER during “Asleep DBS” under general anesthesia (GA). The differences in MER, target accuracy, and prognosis under different anesthesia methods were analyzed. Additionally, the MER length was compared with the postoperative electrode length by electrode reconstruction and measurement. The MER length of two groups was 5.48 ± 1.39 mm in the local anesthesia (LA) group and 4.38 ± 1.43 mm in the GA group, with a statistical significance between the two groups (p < 0.01). The MER length of the LA group was longer than its postoperative electrode length (p < 0.01), however, there was no significant difference between the MER length and postoperative electrode length in the GA group (p = 0.61). There were also no significant differences in the postoperative electrode length, target accuracy, and postoperative primary and secondary outcome scores between the two groups (p > 0.05). These results demonstrate that “Asleep DBS” under GA is comparable to “Awake DBS” under LA. GA has influences on MER during surgery, but typical STN discharges can still be recorded. MER is not an unnecessary surgical procedure.