ArticleJournal of neurosurgery2023
Association of clinical outcomes and connectivity in awake versus asleep deep brain stimulation for Parkinson disease.
Article in Journal of neurosurgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Asleep versus awake deep brain stimulation in the treatment of Parkinson disease: a systematic review and meta-analysis.Journal of neurology · 2025Pooled it
- Awake versus Asleep Anesthesia in Deep Brain Stimulation Surgery for Parkinson's Disease: A Systematic Review and Meta-Analysis.Stereotactic and functional neurosurgery · 2024Pooled it
- Deep Brain Stimulation Response Circuits in Obsessive-Compulsive Disorder.Biological psychiatry · 2026Review
- The graded effect of propofol in electrophysiology-guided navigation during deep brain stimulation surgery.NPJ Parkinson's disease · 2026Article
- Modulatory mechanism of the paraventricular thalamus (PVT) under general anesthesia.Frontiers in pharmacology · 2026Review
- Long-Term Surgical Outcomes and Influential Factors of Subthalamic Nucleus Deep Brain Stimulation for Dyskinesia in Parkinson's Disease: A 3-Year Longitudinal Cohort Study.Clinical interventions in aging · 2026Article
- Ethical considerations of deep brain stimulation for treatment refractory schizophrenia: surveying stakeholders.BMC psychiatry · 2025Article
- Optimal Stimulation Sites and Connectomes for GPi and STN-DBS in Cervical Dystonia.CNS neuroscience & therapeutics · 2025Article
- Comparative effects of deep brain stimulation in subthalamic nucleus and globus pallidus interna on verbal fluency and working memory in adult populations with parkinson's disease: A systematic review.Clinical parkinsonism & related disorders · 2025Review
- Subthalamic Deep Brain Stimulation under General Anaesthesia for Parkinson's Disease: Institutional Experience and Outcomes.Stereotactic and functional neurosurgery · 2025Article
- Short-term 30-day adverse events following awake versus asleep deep brain stimulation for movement disorders: a nationwide registry-based study.Brain & spine · 2025Article
- Structural Connectivity of the Basal Ganglia from Patient-Individual Tractography Is Key for Understanding the Effects of Deep Brain Stimulation in Parkinson's Disease.Stereotactic and functional neurosurgery · 2025Article
- Application of multimodal deep learning and multi-instance learning fusion techniques in predicting STN-DBS outcomes for Parkinson's disease patients.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2024Article
- Intraoperative physiology augments atlas-based data in awake deep brain stimulation.Journal of neurology, neurosurgery, and psychiatry · 2023Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
objectiveDeep brain stimulation (DBS) for Parkinson disease (PD) is traditionally performed with awake intraoperative testing and/or microelectrode recording. Recently, however, the procedure has been increasingly performed under general anesthesia with image-based verification. The authors sought to compare structural and functional networks engaged by awake and asleep PD-DBS of the subthalamic nucleus (STN) and correlate them with clinical outcomes.
methodsLevodopa equivalent daily dose (LEDD), pre- and postoperative motor scores on the Movement Disorders Society-Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III), and total electrical energy delivered (TEED) at 6 months were retroactively assessed in patients with PD who received implants of bilateral DBS leads. In subset analysis, implanted electrodes were reconstructed using the Lead-DBS toolbox. Volumes of tissue activated (VTAs) were used as seed points in group volumetric and connectivity analysis.
resultsThe clinical courses of 122 patients (52 asleep, 70 awake) were reviewed. Operating room and procedure times were significantly shorter in asleep cases. LEDD reduction, MDS-UPDRS III score improvement, and TEED at the 6-month follow-up did not differ between groups. In subset analysis (n = 40), proximity of active contact, VTA overlap, and desired network fiber counts with motor STN correlated with lower DBS energy requirement and improved motor scores. Discriminative structural fiber tracts involving supplementary motor area, thalamus, and brainstem were associated with optimal clinical improvement. Areas of highest structural and functional connectivity with VTAs did not significantly differ between the two groups.
conclusionsCompared to awake STN DBS, asleep procedures can achieve similarly optimal targeting-based on clinical outcomes, electrode placement, and connectivity estimates-in more efficient procedures and shorter operating room times.
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