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
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
