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Related Experiment Video

Updated: Mar 29, 2026

MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor
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"Asleep" deep brain stimulation for essential tremor.

Tsinsue Chen1, Zaman Mirzadeh1, Kristina Chapple1

  • 1Divisions of 1 Neurological Surgery and.

Journal of Neurosurgery
|November 28, 2015
PubMed
Summary

Deep brain stimulation (DBS) for essential tremor can now be performed safely and effectively under general anesthesia ("asleep" DBS). This technique, using indirect targeting of the ventral intermediate nucleus (VIM), shows comparable outcomes to awake procedures.

Keywords:
AC-PC = anterior commissural-posterior commissuralADL = activities of daily livingDBS = deep brain stimulationHOB = head of bedIC = intercommissuralVIM = ventral intermediate nucleusasleep DBSessential tremorfunctional neurosurgeryiCT = intraoperative CTintraoperative imaging

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Area of Science:

  • Neurosurgery
  • Neurology
  • Medical Devices

Background:

  • Deep brain stimulation (DBS) is a common treatment for essential tremor.
  • Traditionally, DBS for essential tremor requires patients to be awake for intraoperative testing.
  • Performing DBS under general anesthesia (

Purpose of the Study:

  • To evaluate the efficacy and safety of "asleep" DBS for essential tremor using indirect targeting of the ventral intermediate nucleus (VIM).
  • To compare outcomes of asleep DBS with traditional awake DBS for essential tremor.

Main Methods:

  • Retrospective review of essential tremor DBS cases performed by a single surgeon.
  • Comparison of two cohorts: awake DBS (n=40) and asleep DBS (n=17) under general anesthesia.
  • Standardized MRI-based anatomical coordinates for VIM targeting, with intraoperative CT for lead confirmation.

Main Results:

  • No significant difference in preoperative or postoperative functional outcomes (Bain and Findley scores) between asleep and awake cohorts.
  • Asleep DBS demonstrated lower Euclidean and radial targeting errors compared to awake DBS.
  • No perioperative complications were reported in either group.

Conclusions:

  • "Asleep" DBS for essential tremor is a safe and effective alternative to awake procedures.
  • Indirect VIM targeting under general anesthesia is feasible without intraoperative stimulation.
  • This approach may offer advantages in targeting accuracy and patient comfort.