Subthalamic Deep Brain Stimulation under General Anaesthesia for Parkinson's Disease: Institutional Experience and...

Area of Science:

• Neurosurgery
• Neurology
• Medical Technology

Background:

• Direct targeting in deep brain stimulation (DBS) enhances surgical experience and logistics.
• Intraoperative imaging allows safe electrode placement under general anesthesia.
• Limited data exists on DBS under general anesthesia in moderate caseload centers outside clinical trials.

Purpose of the Study:

• To evaluate the safety and efficacy of asleep subthalamic deep brain stimulation (DBS) for Parkinson's disease in a general clinical practice setting.
• To assess clinical, motor, medication, and quality-of-life outcomes after DBS surgery performed under general anesthesia.
• To analyze surgical parameters including duration, length of stay, and complications.

Main Methods:

• Prospective single-center study of 89 Parkinson's disease patients undergoing subthalamic DBS between January 2021 and December 2022.
• Outcomes evaluated 6 months post-optimal programming, comparing pre- and post-operative measures.
• Statistical analysis using Wilcoxon test for repeated measures and analysis of surgical parameters.

Main Results:

• Mean surgical duration was 217 minutes; mean length of stay was 3 days.
• One surgical-related complication (delayed infection) occurred; no intraoperative electrode replacements were needed.
• Significant improvements observed in motor function (UPDRS III decrease of 62%) and quality of life (PDQ-8 increase of 50%), with a 68% reduction in medication dosage.

Conclusions:

• Deep brain stimulation (DBS) can be safely and effectively performed under general anesthesia in a pragmatic clinical environment.
• A multidisciplinary team and careful patient selection are crucial for successful implementation.
• The study demonstrates that the benefits of DBS seen in clinical trials can be replicated in routine practice, with considerations for team learning curves and technological adaptation.