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Intra-Operative Behavioral Tasks in Awake Humans Undergoing Deep Brain Stimulation Surgery
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Awake Testing during Deep Brain Stimulation Surgery Predicts Postoperative Stimulation Side Effect Thresholds.

Harrison C Walker1, Jesse Faulk2, Akm Fazlur Rahman3

  • 1Departments of Neurology and Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL 35294, USA. hcwalker@uabmc.edu.

Brain Sciences
|February 21, 2019
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Summary
This summary is machine-generated.

Intraoperative awake testing during deep brain stimulation (DBS) surgery predicts side effects. This helps surgeons adjust electrode placement, improving patient outcomes and anticipating stimulation side effects during later clinical activation.

Keywords:
awake behavioral testingdeep brain stimulationmovement disorders

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Area of Science:

  • Neurosurgery
  • Neurology
  • Biomedical Engineering

Background:

  • Deep brain stimulation (DBS) is established for movement disorders.
  • Electrode targeting under general anesthesia is gaining interest.
  • Predictive value of awake macrostimulation for side effects is unknown.

Purpose of the Study:

  • To determine if intraoperative awake macrostimulation predicts postoperative stimulation side effects.
  • To assess the impact of awake testing on surgical decision-making.

Main Methods:

  • Retrospective review of 384 DBS electrode implants for movement disorders.
  • Characterization of stimulus amplitude thresholds for dose-limiting side effects during surgery.
  • Analysis of predictive value for postoperative side effects using odds ratios and confidence intervals.

Main Results:

  • Intraoperative testing led to DBS electrode repositioning in 37.5% of cases.
  • Dose-limiting stimulation side effects during surgery predict postoperative side effects.
  • Side effect thresholds in clinic occur at lower amplitudes than in surgery.

Conclusions:

  • Awake clinical testing during DBS targeting influences surgical decisions.
  • Intraoperative side effect thresholds predict postoperative stimulation-related side effects.