Evidence map›Paper›PMID 38636468›Full record

SynthesisStereotactic and functional neurosurgery2024

Awake versus Asleep Anesthesia in Deep Brain Stimulation Surgery for Parkinson's Disease: A Systematic Review and Meta-Analysis.

Michelle L Lim, Angela B B Zhan, Sherry J Liu, Seyed E Saffari, Wei Li, Mavis M Teo, Theodore G-L Wong, Wai H Ng, Kai R Wan

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Stereotactic and functional neurosurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Comparative pharmacovigilance of Levodopa and Pramipexole: a disproportionality analysis of the FAERS database.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
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  5. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Michelle L LimDepartment of Surgical Intensive Care, Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore, Singapore.
Angela B B ZhanDepartment of Nursing, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore, Singapore.
Sherry J LiuDepartment of Neurosurgery, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore, Singapore, jiani301@gmail.com.
Seyed E SaffariCentre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.
Wei LiDepartment of Nursing, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore, Singapore.
Mavis M TeoDepartment of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore, Singapore.
Theodore G-L WongDepartment of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Singapore, Singapore.
Wai H NgDepartment of Neurosurgery, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore, Singapore.
Kai R WanDepartment of Neurosurgery, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDeep brain stimulation (DBS) is a well-established surgical therapy for patients with Parkinsons' Disease (PD). Traditionally, DBS surgery for PD is performed under local anesthesia, whereby the patient is awake to facilitate intraoperative neurophysiological confirmation of the intended target using microelectrode recordings. General anesthesia allows for improved patient comfort without sacrificing anatomic precision and clinical outcomes.

methodsWe performed a systemic review and meta-analysis on patients undergoing DBS for PD. Published randomized controlled trials, prospective and retrospective studies, and case series which compared asleep and awake techniques for patients undergoing DBS for PD were included. A total of 19 studies and 1,900 patients were included in the analysis.

resultsWe analyzed the (i) clinical effectiveness - postoperative UPDRS III score, levodopa equivalent daily doses and DBS stimulation requirements. (ii) Surgical and anesthesia related complications, number of lead insertions and operative time (iii) patient's quality of life, mood and cognitive measures using PDQ-39, MDRS, and MMSE scores. There was no significant difference in results between the awake and asleep groups, other than for operative time, for which there was significant heterogeneity.

conclusionWith the advent of newer technology, there is likely to have narrowing differences in outcomes between awake or asleep DBS. What would therefore be more important would be to consider the patient's comfort and clinical status as well as the operative team's familiarity with the procedure to ensure seamless transition and care.

Indexed as

Deep Brain StimulationParkinson DiseaseWakefulnessAnesthesiaAnesthesia, GeneralHumansTreatment OutcomeAnesthesiaCentral nervous system diseaseDeep brain stimulationElectric stimulationMovement disordersParkinson disease

Identifiers

PMID38636468
PMCPMC11152021

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.