Abstract:
BACKGROUND:Deep brain stimulation (DBS) implantation under general anesthesia (GA) is of great importance for patients with disabling off-medication symptoms or medical comorbidities. However, the relative advantages/disadvantages of routine local anesthesia (LA) surgery versus GA regarding clinical outcomes are controversial, and the safety of DBS implantation under GA is debatable. SUMMARY:We systematically reviewed the literature to compare the efficacy and safety of awake and asleep DBS surgery. We identified cohort studies from the Cochrane library, MEDLINE, and EMBASE (January 1970 to August 2019) by using Review Manager 5.3 software to conduct a meta-analysis following the PRISMA guidelines. Fourteen cohort studies involving 1,523 patients were included. The meta-analysis results showed that there were no significant differences between the GA and LA groups in UPDRSIII score improvement (standard mean difference [SMD] 0.06; 95% CI -0.16 to 0.28; p = 0.60), postoperative LEDD requirement (SMD -0.17; 95% CI -0.44 to 0.12; p = 0.23), or operation time (SMD 0.18; 95% CI -0.31 to 0.67; p = 0.47). Additionally, there was no significant difference in the incidence of adverse events (OR 0.98; 95% CI 0.53-1.80; p = 0.94), including postoperative speech disturbance and intracranial hemorrhage. However, the volume of intracranial air was significantly lower in the GA group than that in the LA group. In a subgroup analysis, there was no significant difference in clinical efficacy between the microelectrode recording (MER) and non-MER groups. We demonstrated equivalent clinical outcomes of DBS surgery between GA and LA in terms of improvement of symptoms and the incidence of adverse events. Key Messages: MER might not be necessary for DBS implantation. For patients who cannot tolerate DBS surgery while being awake, GA should be an appropriate alternative.
journal_name
Stereotact Funct Neurosurgjournal_title
Stereotactic and functional neurosurgeryauthors
Liu Z,He S,Li Ldoi
10.1159/000505079subject
Has Abstractpub_date
2019-01-01 00:00:00pages
381-390issue
5-6eissn
1011-6125issn
1423-0372pii
000505079journal_volume
97pub_type
杂志文章,meta分析,评审abstract::Interstitial hyperthermia of malignant brain tumors has been produced by a heated ferromagnetic implant with a low Curie point. Induction heating of the implant, which is stereotactically implanted in a tumor, is obtained by eddy currents in a high-frequency magnetic field. Safe, repeated and long-term treatment of 35...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098928
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:A patient controller (PC) is an optional device for patients with deep brain stimulation (DBS) to have limited control of their stimulator system. OBJECTIVES:We investigated the impact of a PC on DBS safety, most notably the handling/prevention of unexpected DBS failure in patients with Parkinson's disease ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000329361
更新日期:2011-01-01 00:00:00
abstract::To elucidate the radiobiological effect of Gamma Knife radiosurgery on brain tumors, we performed a histological study on nine cases. In two, the material was obtained at autopsy and in seven following surgery. In the central region of the radiation field, destructive changes occurred both in tumor cells and in vessel...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099695
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Adjustment of the motor circuitry has been described in the treatment of Parkinson disease (PD). OBJECTIVES:To evaluate the modulation of the motor circuitry of PD patients by subthalamic deep brain stimulation (STN DBS) using 18F-fluorodeoxyglucose (FDG) and positron emission tomography (PET). METHODS:Res...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000455930
更新日期:2017-01-01 00:00:00
abstract::The authors assess the accuracy of targeting nucleus ventralis intermedius (Vim) with fast spin echo inversion recovery (FSE/IR) magnetic resonance imaging (MRI) in 18 successful deep brain stimulator (DBS) implants for medically refractory tremor. FSE/IR-MRI-derived coordinates are compared to the final coordinates e...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000029718
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Applications in clinical medicine can benefit from fusion of spectroscopy data with anatomical imagery. For example, new 3-dimensional (3D) spectroscopy techniques allow for improved correlation of metabolite profiles with specific regions of interest in anatomical tumor images, which can be useful in charac...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000363751
更新日期:2014-01-01 00:00:00
abstract::In his keynote address, the author reviews early work in the surgical management of the epilepsies and presents a state-of-the-art review of current basic science and clinical indications for and results from corpus callosotomy for the treatment of seizure disorders. ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000098621
更新日期:1994-01-01 00:00:00
abstract::In order to shed light on the first application of human functional stereotactic neurosurgery, whether it was in the realm of movement disorders, as has been claimed repeatedly, or in the realm of psychiatry, a review of the original scholarly literature was conducted. Tracking and scrutinising original publications b...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章,评审
doi:10.1159/000496157
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Stereotactic procedures are image guided, often using magnetic resonance (MR) images limited by image distortion, which may influence targets for stereotactic procedures. OBJECTIVES:The aim of this work was to assess methods of identifying target coordinates for stereotactic procedures with MR in multiple p...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000488396
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVES:Experimental data and case reports of patients with intractable epilepsy treated with deep brain stimulation (DBS) of the subthalamic nucleus (STN) suggest a considerable anticonvulsant effect. However, no satisfactory mechanisms of action have yet been elucidated. We investigated the putative therapeutic me...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000086867
更新日期:2005-01-01 00:00:00
abstract::Computed tomographic (CT), magnetic resonance (MR), MR angiographic and angiographic images, obtained after complete nidus obliteration had been angiographically confirmed, were reviewed in 9 patients who had undergone Gamma Knife treatment for cerebral arteriovenous malformations (AVMs). The period between angiograph...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098772
更新日期:1995-01-01 00:00:00
abstract::Treatment of patients with nasopharyngeal carcinoma (NPC) using external beam radiation therapy (XRT) alone results in significant local recurrence. To improve local control, stereotactic radiosurgery (SRS) was used to boost radiation to the primary tumor site following XRT in 23 patients with NPC. SRS was delivered u...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000029753
更新日期:1999-01-01 00:00:00
abstract::A 25-year-old woman with a large acoustic schwannoma underwent surgical excision 18 months after Gamma Knife radiosurgery because of transient expansion of the tumor causing ataxia. Histopathologial investigation by the TUNEL method revealed the presence of some apoptotic cells. The findings were compared with finding...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000056411
更新日期:1998-10-01 00:00:00
abstract::Fractionated stereotactic radiotherapy is a method which attempts to combine the radiobiological advantages offered by dose fractionation with a technique for focal delivery of radiation. At McGill University, fractionated stereotactic radiotherapy is given with a linear accelerator-based dynamic stereotactic radiosur...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098941
更新日期:1992-01-01 00:00:00
abstract::A 10-year follow-up study of neuroelectric implant integrity has been completed for 27 subjects who were treated for movement disorders associated with cerebral palsy. Data used for analysis included X-ray material, clinical data, and results from electrophysiological testing. Of the 21 subjects with subcutaneous rece...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099487
更新日期:1989-01-01 00:00:00
abstract::Clinical experience with the use of pergolide is presented in 55 patients with Parkinson's disease. Fifty to 900 micrograms/day (mean 242.73, SD 217.51) of pergolide and 0.64-17.05 micrograms/kg/day (mean 4.58, SD 4.25) pergolide was given together with L-carbidopa to 29 males and 26 females for a period of up to 2 ye...
journal_title:Stereotactic and functional neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1159/000099849
更新日期:1997-01-01 00:00:00
abstract::We examined the direct effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) on levodopa-induced peak-dose dyskinesia in 45 patients with Parkinson's disease (PD) without reducing the levodopa dosage during the early period after surgery. In 8 patients (18%), the dyskinesia was quickly attenuated by bi...
journal_title:Stereotactic and functional neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1159/000094957
更新日期:2006-01-01 00:00:00
abstract::A computerized method of determining the focal point of electrical activity in the pallidum of parkinsonian patients was developed using on-line quantitative physiological data analysis. Thirty patients in a series of 70 were studied in depth. Neuronal activity was recorded from the pallidum using a semi-microelectrod...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000048378
更新日期:2000-01-01 00:00:00
abstract::At the 1989 meeting of the World Society for Stereotactic and Functional Neurosurgery in Maebashi, the authors presented the concept and design of a stereotactic neurosurgical robot. The first prototype has now been completed and has entered clinical testing. The characteristics are as follows. The robot is positioned...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100300
更新日期:1994-01-01 00:00:00
abstract:INTRODUCTION:The intersection of Bejjani's line with the well-delineated medial subthalamic nucleus (STN) border on MRI has recently been proposed as an individualized reference in subthalamic deep brain stimulation (DBS) surgery for Parkinson's disease (PD). We, therefore, aimed to investigate the applicability across...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000510802
更新日期:2020-11-18 00:00:00
abstract::Current neuronavigational systems face two primary challenges: (1) automatic and robust registration between preoperative images and the operating room space, and (2) compensation for brain deformations that compromise the accuracy of the initial registration. To contend with these difficulties, we firstly estimate th...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000075171
更新日期:2003-01-01 00:00:00
abstract::Following deep brain stimulation (DBS) surgery, a variety of potential mechanical or functional complications ranging from perioperative events to hardware malfunction may occur. We present 2 patients who developed a unique complication of cyst formation at the tip of the DBS electrode in the absence of infection. One...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000350021
更新日期:2013-01-01 00:00:00
abstract::The author has performed 108 stereotactic thalamotomies using MRI (MGSTs) without ventriculography in 77 cerebral palsy (CP) patients with dyskinesia(s) from January 1992 to January 1997. The clinical results were verified in terms of improvement of major preoperative symptom and patient's (or relative's) satisfaction...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099891
更新日期:1997-01-01 00:00:00
abstract::We have analyzed a series of 225 patients with intracranial metastases (343 lesions), treated in our department by Gamma Knife radiosurgery over a 30-month period. We have used a modified Pittsburgh protocol and performed 242 procedures on 164 single/78 multiple lesions. Primary tumors were mostly carcinomas of the lu...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099809
更新日期:1996-01-01 00:00:00
abstract::Twiddler's syndrome describes the intentional external manipulation or spontaneous rotation of implanted devices such as cardiac pacemakers. Here we report the same phenomenon occurring in a patient with an implanted deep brain stimulator generator. The clinical syndrome is described and potential technical nuances to...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000155231
更新日期:2008-01-01 00:00:00
abstract::Corpus callosotomy is a viable treatment for patients with refractory generalized or multifocal epilepsy, particularly those who have drop attacks. Laser interstitial thermal therapy (LITT) is a minimally invasive surgical option for various intracranial lesions. In this report, we present a 2-trajectory thermal ablat...
journal_title:Stereotactic and functional neurosurgery
pub_type:
doi:10.1159/000495414
更新日期:2018-01-01 00:00:00
abstract::Small pellets loaded with apomorphine, thyrotropin-releasing hormone, and bromocriptine were implanted into the right striatum of 6-hydroxydopamine-treated rotation rats, and the efficacy of this drug delivery system was examined. Pellets containing neuromodifying agents, when implanted into the brain, may be just as ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100232
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:A therapeutic radiosurgery procedure usually follows a separate diagnostic stereotactic procedure after days or weeks. OBJECTIVES:To define the clinical reliability, safety, and cost implications of same-day diagnostic stereotactic biopsy and therapeutic radiosurgery. METHODS:During an 8-year interval, 26 ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000332057
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:To investigate the effects of low- and high-frequency deep brain stimulation (DBS) on the nucleus accumbens (ACC) and the adjacent internal capsule in 3 patients with obsessive-compulsive disorder (OCD) using blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) under intraope...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000368805
更新日期:2015-01-01 00:00:00
abstract::Subacute and chronic continuous electrical stimulation at the epileptic focus in the hippocampus or parahippocampal cortex at 130 Hz, 0.21-1.0 ms, 2.5-3.5 V (about 200-300 microA) induces a decrease in focal EEG epileptic interictal activity and also in the occurrence of clinical seizures. This may represent an altern...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000064610
更新日期:2001-01-01 00:00:00