PMID- 33325608 OWN - NLM STAT- MEDLINE DCOM- 20210818 LR - 20220210 IS - 1525-1403 (Electronic) IS - 1094-7159 (Linking) VI - 24 IP - 2 DP - 2021 Feb TI - Asleep Deep Brain Stimulation in Patients With Isolated Dystonia: Stereotactic Accuracy, Efficacy, and Safety. PG - 272-278 LID - 10.1111/ner.13341 [doi] AB - OBJECTIVES: Lead placement for deep brain stimulation (DBS) is routinely performed using neuroimaging or microelectrode recording (MER). Recent studies have demonstrated that DBS under general anesthesia using an imaging-guided target technique ("asleep" DBS) can be performed accurately and effectively with lower surgery complication rates than the MER-guided target method under local anesthesia ("awake" DBS). This suggests that asleep DBS may be a more acceptable method. However, there is limited direct evidence focused on isolated dystonia using this method. Therefore, this study aimed to investigate the clinical outcomes and targeting accuracy in patients with dystonia who underwent asleep DBS. MATERIALS AND METHODS: We examined 56 patients (112 leads) with isolated dystonia who underwent asleep DBS targeting in the globus pallidus internus (GPi) and subthalamic nucleus (STN). The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) scores were assessed preoperatively and at 12-month follow-up (12 m-FU). The lead accuracy was evaluated by comparing the coordinates of the preoperative plan with those of the final electrode implantation location. Other measures analyzed included stimulation parameters and adverse events (AEs). RESULTS: For both GPi and STN cohorts, mean BFMDRS motor scores were significantly lower at 12 m-FU (8.9 +/- 10.9 and 4.6 +/- 5.7 points) than at baseline (22.6 +/- 16.4 and 16.1 +/- 14.1 points, p < 0.001). The mean difference between the planned target and the distal contact of the leads was 1.33 +/- 0.54 mm for the right brain electrodes and 1.50 +/- 0.57 mm for the left, determined by Euclidian distance. No perioperative complications or AEs related to the device were observed during the complete follow-up. However, AEs associated with stimulation occurred in 12 and 6 patients in the GPi and STN groups, respectively. CONCLUSIONS: Asleep DBS may be an accurate, effective, and safe method for treating patients with isolated dystonia regardless of the stimulation target. CI - (c) 2020 International Neuromodulation Society. FAU - Li, Hongxia AU - Li H AD - Department of Neurology & Institute of Neurology, Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Wang, Tao AU - Wang T AD - Department of Neurosurgery, Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - Center for Functional Neurosurgery, Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Zhang, Chencheng AU - Zhang C AUID- ORCID: 0000-0003-4472-4134 AD - Department of Neurosurgery, Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - Center for Functional Neurosurgery, Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Su, Daoqing AU - Su D AD - Department of Neurosurgery, Liaocheng People's Hospital and Liaocheng Clinical School of Shandong First Medical University, Liaocheng, China. FAU - Lai, Yijie AU - Lai Y AD - Department of Neurosurgery, Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - Center for Functional Neurosurgery, Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Sun, Bomin AU - Sun B AD - Department of Neurosurgery, Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - Center for Functional Neurosurgery, Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Li, Dianyou AU - Li D AUID- ORCID: 0000-0003-4212-4231 AD - Department of Neurosurgery, Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - Center for Functional Neurosurgery, Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Wu, Yiwen AU - Wu Y AUID- ORCID: 0000-0001-6059-7054 AD - Department of Neurology & Institute of Neurology, Ruijin Hospital, affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China. LA - eng GR - 81771482/National Natural Science Foundation of China/ GR - 81870887/National Natural Science Foundation of China/ PT - Journal Article DEP - 20201216 PL - United States TA - Neuromodulation JT - Neuromodulation : journal of the International Neuromodulation Society JID - 9804159 SB - IM MH - *Deep Brain Stimulation MH - *Dystonia/therapy MH - *Dystonic Disorders/therapy MH - Globus Pallidus MH - Humans MH - Treatment Outcome OTO - NOTNLM OT - Asleep DBS OT - deep brain stimulation OT - globus pallidus internus OT - isolated dystonia OT - subthalamic nucleus EDAT- 2020/12/17 06:00 MHDA- 2021/08/19 06:00 CRDT- 2020/12/16 08:46 PHST- 2020/07/27 00:00 [received] PHST- 2020/11/17 00:00 [revised] PHST- 2020/11/17 00:00 [accepted] PHST- 2020/12/17 06:00 [pubmed] PHST- 2021/08/19 06:00 [medline] PHST- 2020/12/16 08:46 [entrez] AID - S1094-7159(21)00090-8 [pii] AID - 10.1111/ner.13341 [doi] PST - ppublish SO - Neuromodulation. 2021 Feb;24(2):272-278. doi: 10.1111/ner.13341. Epub 2020 Dec 16.