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. 2016 Apr-Jun;28(2):63-67.
doi: 10.1016/j.tcmj.2016.02.003. Epub 2016 Apr 10.

Neurophysiological comparisons of subthalamic deep-brain stimulation for Parkinson's disease between patients receiving general and local anesthesia

Sheng-Tzung Tsai  1 , Chung-Chih Kuo  2 , Tsung-Ying Chen  3 , Shin-Yuan Chen  1
Affiliations

Neurophysiological comparisons of subthalamic deep-brain stimulation for Parkinson's disease between patients receiving general and local anesthesia

Sheng-Tzung Tsai et al. Tzu Chi Med J. 2016 Apr-Jun.

Abstract

Objectives: Subthalamic nucleus deep-brain stimulation (STN-DBS) is suggested as a standard treatment for patients with Parkinson's disease (PD) and drug-related side effects. Most centers perform the operation under local anesthesia (LA) to ensure better microelectrode recording (MER). Given the advances in imaging and MER, general anesthesia (GA) is perceived as an alternative choice for PD patients undergoing STN-DBS. However, the outcomes in terms of clinical symptoms and MER after GA have rarely been reported. In this report, we compared the outcomes after STN-DBS for PD between patients receiving LA and GA.

Materials and methods: We included 16 patients with comparable severity of PD undergoing either GA (n = 8) or LA (n = 8) for STN-DBS. MER was performed in all patients for STN localization, and surgical outcomes were evaluated using the Unified PD Rating Scales, and Mini-mental status examination. All adverse effects were documented.

Results: Both groups (GA and LA) acquired similar benefits from STN-DBS, and there were no significant differences in neuropsychiatric outcome analysis between groups. There were no significant differences in stimulation parameters and adverse effects from STN-DBS between groups. The GA group had a trend toward a lower frequency rate of STN firing on MER.

Conclusion: Although the GA group has a lower neuronal firing frequency in the STN during surgery, STN-DBS under GA showed comparable and non-inferior outcomes as compared with STN-DBS under LA.

Keywords: Deep-brain stimulation; General anesthesia; Parkinson's disease.

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Conflict of interest statement

Conflicts of interest: none.

Figures

Fig. 1
Fig. 1
Representative raw neuronal firings from the subthalamic nucleus in patients with Parkinson's disease under general and local anesthesia.
See this image and copyright information in PMC

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