Motor Function and Quality of Life Improvement following Asleep versus Awake Deep Brain Stimulation (DBS) Procedures
Jan Vesper1, Guenther Deuschl2, Lilly Chen3, Roshini Jain3
1Heinrich Heine University Düsseldorf, 2University Hospital Schleswig-Holstein, Campus Kiel, 3Boston Scientific Neuromodulation
Objective:

To compare real-world outcomes in patients with Parkinson’s disease (PD) whose Deep Brain Stimulation (DBS) leads were implanted using asleep procedures versus those patients that underwent the procedure using awake conditions.

Background:

DBS procedures are typically conducted with patients being awake to allow for intraoperative clinical testing and/or micro-electrode recording to confirm lead location. However, asleep DBS procedures (i.e., under general anesthesia) are becoming increasingly popular due, at least in part, to technological improvements in imaging allowing alternative lead placement confirmation and shorter procedure duration (Brodsky 2017, Chen 2018, Vinke 2022).

Design/Methods:

A sub-analysis of patients receiving their DBS lead implant under asleep versus awake conditions was conducted in an ongoing, large,  multicenter, prospective real-world outcomes study (Vercise, Boston Scientific). Motor function (MDS-UDPRS III), quality of life (PDQ-39) and related outcomes (GIC) were collected at baseline and up to 3-years. Safety events were also collected.

Results:

To date, 157 patients (mean age 61.2±8.3 years; 69% male) were asleep and 433 (mean age 60.1±8.5 years; 66% male) were awake during lead placement. Patients in both groups presented with similar baseline age, duration of disease and disease state. Improvement in quality-of-life was noted in both groups with a 5.3-point improvement (n = 104) in asleep group and a 4.5-point improvement (n = 319) in awake group at 1-year. Similarly, an 18.8- and 20.9-point improvement in motor function was noted in the asleep and awake groups, respectively.

Conclusions:

Outcomes from this large dataset of real-world outcomes examining the outcomes following asleep versus awake DBS demonstrate an alignment with results from previous studies (Holewijn 2021; LaHue 2017). Patient outcomes show little to no difference between awake versus asleep groups. Sleep DBS procedures may offer potential for shortening the total time taken for DBS procedures and offer a viable alternative for patients.

10.1212/WNL.0000000000201926