Objective: To employ a means of implanting DBS leads to the GPi in individuals with Parkinson’s disease who are undergoing the surgery under general anesthesia and to assess the clinical outcome.

Background: A consistent challenge for patients with Parkinson’s disease during DBS surgery is the awake portion of the surgery. Discomfort and anxiety during the awake portion of the surgery results in the exclusion of patients, who would otherwise be good candidates for DBS, and to miss out on the benefits of this therapy. Based on our experience implanting DBS leads in the GPi of individuals with dystonia, we have adapted our procedures to implant DBS leads in patients with PD while they are under general anesthesia.

Methods: 3T MR-based imaging, including susceptibility weighted imaging (SWI), to identify target locations in GPi. Reversed staging for DBS implantion under general anesthesia (typically ∼ 1.2 – 1.8% sevoflurane). Single-pass MER per side and macrostimulation to identify side effects. CRW frame-based stereotactic placement of DBS leads. UPDRS evaluation before and after surgery.

Results: Over 60 individuals with Parkinson’s disease have received DBS lead implants to the GPi while undergoing the surgery asleep at our center. MER identification of GPe and GPi during surgery aid in intraoperative decision making. Adverse events profile comparable to standard surgery. In 16 individuals who have undergone post-surgery UPDRS assessment 6 to 18 months after surgery, motor scores effects are comparable to published outcomes.

Conclusions: Implanting DBS leads while individuals are under general anesthesia and performing MER provides an alternative means of offering DBS therapy to individuals with Parkinson’s disease.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/employing-intraoperative-microelectrode-recordings-during-asleep-deep-brain-stimulation-surgery-of-the-globus-pallidus-internus-in-parkinsons-disease/