Bilateral Subthalamic Nucleus Deep Brain Stimulation under General Anesthesia: Literature Review and Single Center Experience

Journal of Clinical Medicine

Woong-Woo Lee¹  Beomseok Jeon²  Han-Joon Kim²  Kwang Hyon Park³  Kawngwoo Park⁴  Jae Meen Lee⁵  Yong Hoon Lim⁶  Sun Ha Paek⁶  Eun Jin Song⁶  Hye Ran Park⁷ 

[1] Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul 01830, Korea;Department of Neurology, Seoul National University Hospital, Seoul 03080, Korea;Department of Neurosurgery, Chuungnam National University Sejong Hospital, Sejong 30099, Korea;Department of Neurosurgery, Gachon University Gil Medical Center, Incheon 21565, Korea;Department of Neurosurgery, Pusan National University Hospital, Busan 49241, Korea;Department of Neurosurgery, Seoul National University Hospital, Seoul 03080, Korea;Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul 04401, Korea;

关键词: general anesthesia;    intraoperative computed tomography;    intraoperative magnetic resonance imaging;    local anesthesia;    microelectrode recording;    Parkinson’s disease;   

DOI  :  10.3390/jcm9093044

来源: DOAJ

【 摘 要 】

Bilateral subthalamic nucleus (STN) Deep brain stimulation (DBS) is a well-established treatment in patients with Parkinson’s disease (PD). Traditionally, STN DBS for PD is performed by using microelectrode recording (MER) and/or intraoperative macrostimulation under local anesthesia (LA). However, many patients cannot tolerate the long operation time under LA without medication. In addition, it cannot be even be performed on PD patients with poor physical and neurological condition. Recently, it has been reported that STN DBS under general anesthesia (GA) can be successfully performed due to the feasible MER under GA, as well as the technical advancement in direct targeting and intraoperative imaging. The authors reviewed the previously published literature on STN DBS under GA using intraoperative imaging and MER, focused on discussing the technique, clinical outcome, and the complication, as well as introducing our single-center experience. Based on the reports of previously published studies and ours, GA did not interfere with the MER signal from STN. STN DBS under GA without intraoperative stimulation shows similar or better clinical outcome without any additional complication compared to STN DBS under LA. Long-term follow-up with a large number of the patients would be necessary to validate the safety and efficacy of STN DBS under GA.

【 授权许可】

Unknown