Table 1.
A summary of prior systematic review and meta-analysis comparing asleep versus awake DBS surgery for PD
| Author | Ho et al. [7] | Sheshadri et al. [12] | Liu et al. [10] |
|---|---|---|---|
| Year published | 2018 | 2017 | 2020 |
| Journal | Journal of Neurology, Neurosurgery and Psychiatry | The Canadian Journal of Neurological Sciences | Stereotactic and Functional Neurosurgery |
| Systematic review and meta-analysis | Systematic review and meta-analysis | Systematic review and meta-analysis | |
| Date of inclusion | 2004–2015 | 2007–2015 | 2004–2019 |
| No. of studies | 145 | 6 | 14 |
| Retrospective cohort studies | 70 | 6 | 14 |
| Case series, cohort studies | 79 | 0 | 0 |
| Randomized controlled trial | 1 | 0 | 0 |
| Patients, n | 8,382 | 455 | 1,523 |
| Asleep | 7,771 | 194 | 967 |
| Awake | 671 | 261 | 556 |
| Results | |||
|---|---|---|---|
| UPDRS III improvement | No difference | Data suggest a trend toward improved UPDRS III score under awake technique, though statistically insignificant | No difference |
| Postoperative LEDD | No difference | No difference | No difference |
| Adverse events | Not reported | No difference | No difference |
| Adverse effects – related to stimulation | Stimulation-related effects less in awake versus asleep | No difference | No difference |
| Adverse effects – intracranial hemorrhage | Rate of intracranial hemorrhage was lower in asleep group | Not reported | No difference |
| Adverse effects – speech disturbances | Not reported | Not reported | No difference |
| Operating time | No difference | Not reported | No difference |
| Stimulation intensity | Not reported | Not reported | Comparable between awake and asleep groups |
| Postoperative clinical outcomes | Not reported | Not reported | No difference |
| Perioperative complications | Asleep group had lower risk of infection compared to awake group | No difference | No difference |
| Other findings | Asleep group required fewer passes per lead compared to awake group | Not reported | Intracranial air lower in asleep compared to the awake group |
ICH, intracranial hemorrhage; LEDD, Levadopa equivalent daily dose; UPDRS III, Unified Parkinson’s Disease Rating Scale Part III.