CLINICAL TRENDS IN ASLEEP AND AWAKE DBS: COMPARING NORTH AMERICA AND EUROPE
Recommended Citation
Pathadan DS, Dalm B, De Almeida LB, De Jesus S, Fasano A, Foote K, Gordeyeva Y, Jimenez-Shahed J, Pouratian N, Rolston J, Rosenow J, Safarpour D, Schwalb J, Siddiqui M, Spindler M, Tsai A, Wong J, Verhagen-Metman L. CLINICAL TRENDS IN ASLEEP AND AWAKE DBS: COMPARING NORTH AMERICA AND EUROPE. Stereotact Funct Neurosurg 2024; 102(Suppl 8):243.
Document Type
Conference Proceeding
Publication Date
11-11-2024
Publication Title
Stereotact Funct Neurosurg
Keywords
methanol extraction residue, brain depth stimulation, conference abstract, controlled study, Europe, female, human, interventional magnetic resonance imaging, microelectrode, motor dysfunction, MRI scanner, neurologist, neurosurgeon, North America, nuclear magnetic resonance imaging, Parkinson disease, wakefulness
Abstract
Introduction: DBS practices may vary geographically. We aim to compare trends and perceptions regarding Asleep and Awake DBS in North-America (NA) and Europe (EU). Methods: A panel of DBS clinicians sent a survey to DBS clinicians of the Parkinson Study Group, DBS Think-Tank, World Society for Stereotactic and Functional Neurosurgery, and Movement Disorder Society. Results: There were 214 respondents from NA (53% neurosurgeons, 43% Neurologists and 4% APP) and 61 from EU (69%, 30%, and 1%, respectively In NA, 54% perform both asleep and awake, 28% awake only, and 18% asleep only. In EU, these numbers were 66%, 18%, and 16%. In NA, centers performing both awake and asleep DBS (N=60), 75% choose awake for STN, 45% for GPI, 90% for VIM. In EU centers performing both (n=33), 30% choose awake for STN, 0% for GPI and 80% for VIM. For asleep-DBS, NA centers offer i-MRI in 37%, vs EU centers 0%. In NA, microelectrode-recording (MER) is used during asleep-DBS in 27% vs in EU 69% of cases. Whether awake or asleep, single-channel MER is most common in NA vs 2-3 or 4-5 channels in EU. When asked to agree or disagree with: asleep-DBS is equal to or more effective than awake-DBS for each target, NA respondents agreed/disagreed as follows: STN: 28%/43%; GPI: 53%/29%; VIM: 13%/64% vs EU respondents: STN: 53%/35%; GPI: 73%/15%; VIM: 15%/56% (remainder: 'similar' or 'no experience'). When presented with 8 techniques for awake/asleep DBS, the choice for the 'Most optimal technique for each target', was 'awake+MER+test stimulation for STN and VIM (not GPI) in NA and EU. Similarly, when choosing the 'least optimal technique for each target', NA and EU agreed on 'asleep iCT/Oarm' for STN, GPI and VIM. Conclusions: Both continents preferred Awak- DBS for VIM and STN, and Asleep-DBS for GPI. 'The most optimal technique' in NA and EU was 'awake+MER+stim' for STN and VIM, and 'asleep iMRI' for GPI. 'The least optimal technique' for all 3 targets was 'asleep iCT/Oarm' (without physiology) in both continents. In EU, but not NA, asleep-DBS was performed with MER in the majority of cases.
Volume
102
Issue
Suppl 8
First Page
243
