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Related Experiment Video

Updated: Jan 14, 2026

Intra-Operative Behavioral Tasks in Awake Humans Undergoing Deep Brain Stimulation Surgery
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Intraoperative Motor Stimulation During Asleep Subthalamic Nucleus Deep Brain Stimulation Predicts Postoperative

Kazuki Sakakura1, John Pearce1, Nathan Pertsch1

  • 1Department of Neurosurgery, Rush University Medical Center, Chicago , Illinois , USA.

Operative Neurosurgery (Hagerstown, Md.)
|October 27, 2025
PubMed
Summary

Intraoperative motor activation during asleep subthalamic nucleus deep brain stimulation (STN-DBS) predicts postoperative side effects in Parkinson disease patients. Identifying these predictors is crucial for optimizing STN-DBS therapy.

Keywords:
Deep brain stimulationMotor side effectsParkinson diseaseSubthalamic nucleus

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Area of Science:

  • Neurosurgery
  • Neurology
  • Biomedical Engineering

Background:

  • Asleep subthalamic nucleus deep brain stimulation (STN-DBS) offers Parkinson disease (PD) benefits comparable to awake DBS.
  • However, it lacks neurophysiological confirmation, potentially causing postoperative motor side effects and requiring lead revision.
  • Predicting these side effects is essential for improving patient outcomes.

Purpose of the Study:

  • To identify predictors of postoperative motor side effects in asleep STN-DBS for Parkinson disease.
  • To investigate the correlation between intraoperative motor activation and postoperative side effects.
  • To explore the anatomical substrates associated with these side effects.

Main Methods:

  • Retrospective chart review of 19 Parkinson disease patients undergoing asleep STN-DBS.
  • Intraoperative stimulation (120 µs pulse width, <4 mA) and postoperative stimulation (60 µs pulse width, <4 mA) to assess motor activation thresholds.
  • Tractography analysis to delineate corticobulbar, corticospinal, and frontal eye fields tracts.

Main Results:

  • Intraoperative motor activation threshold significantly predicted postoperative motor side effects (P = .021).
  • Corticobulbar and frontal eye fields tracts were significantly closer to STN-DBS contacts than corticospinal tracts (P < .001).

Conclusions:

  • Intraoperative motor activation during asleep STN-DBS is a significant predictor of postoperative motor side effects.
  • Anatomical proximity of tracts like corticobulbar and frontal eye fields to DBS contacts may contribute to side effects.
  • These findings aid in refining asleep STN-DBS techniques to minimize adverse events.