Deep Brain stimulation (DBS) as a neurosurgical treatment modality for movement disorders has evolved significantly since its inception in the early 80s. With rapid technological advancements, the scope of DBS has expanded and now encompasses treatment for refractory epilepsy, chronic pain conditions and certain neuropsychiatric disorders.
The minimally invasive nature of DBS surgery provides a better patient safety and recovery profile when compared to permanent and often more invasive neurosurgical lesioning techniques. Although, the understanding of the postulated mechanisms of DBS treatment is constantly evolving, it continues to offer a modern-day remedy for refractory movement disorders.
The anesthetic considerations for DBS surgery are wide-ranging and any peri-operative planning mandates a multi-disciplinary approach. The anesthetic challenges are not just limited to the provision of sound anesthetic care during the implantation of DBS electrodes but also extend to situations where patients with deep brain stimulators present for non-DBS related surgeries.
Parkinson’s disease Deep brain stimulation Subthalamic nuclei Substantia nigra Intraoperative electrophysiology
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Benabid AL, Pollak P, Louveau A, et al. Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Appl Neurophysiol. 1987;50:344–6.PubMedPubMedCentralGoogle Scholar
DeMaagd G, Philip A. Parkinson’s disease and its management: part 1: disease entity, risk factors, pathophysiology, clinical presentation, and diagnosis. P T. 2015;40(8):504–32.PubMedPubMedCentralGoogle Scholar
Massano J, Bhatia KP. Clinical approach to Parkinson’s disease: features, diagnosis, and principles of management. Cold Spring Harb Perspect Med. 2012;2(6):a008870.CrossRefPubMedCentralPubMedGoogle Scholar
Venkatraghavan L, Luciano M, Manninen P. Anesthetic management of patients undergoing deep brain stimulator insertion. Anesth Analg. 2010;110:1138–45.PubMedPubMedCentralGoogle Scholar
Kocabicak E, Temel Y, Hollig A, et al. Current perspectives on deep brain stimulation for severe neurological and psychiatric disorders. Neuropsychiatr Dis Treat. 2015;11:1051–66.PubMedPubMedCentralGoogle Scholar
Scharpf DT, Sharma M, Deogaonkar M, et al. Practical considerations and nuances in anesthesia for patients undergoing deep brain stimulation implantation surgery. Korean J Anesthesiol. 2015;68:332–9.CrossRefPubMedCentralPubMedGoogle Scholar
Venkatraghavan L, Manninen P. Anesthesia for deep brain stimulation. Curr Anesthesiol Rep. 2016;6(3):233–43.CrossRefGoogle Scholar
Sharma M, Rhiew R, Deogaonkar M, et al. Accuracy and precision of targeting using frameless stereotactic system in deep brain stimulator implantation surgery. Neurol India. 2014;62:503–9.CrossRefPubMedCentralPubMedGoogle Scholar
Sharma M, Deogaonkar M. Accuracy and safety using intraoperative O-arm during placement of deep brain stimulation electrodes without electrophysiological recordings. J Clin Neurosci. 2016;27:80–6.CrossRefPubMedCentralPubMedGoogle Scholar
Yeoh TY, Manninen P, Kalia SK, Venkatraghavan L. Anesthesia considerations for patients with an implanted deep brain stimulator undergoing surgery: a review and update. Can J Anesth. 2017;64:308–19.CrossRefPubMedCentralPubMedGoogle Scholar
Chen SY, Tsai ST, Lin SH, et al. Subthalamic deep brain stimulation in Parkinson’s disease under different anesthetic modalities: a comparative cohort study. Stereotact Funct Neurosurg. 2011;89:372–80.CrossRefPubMedCentralPubMedGoogle Scholar
Kwon WK, Kim JH, Lee JH, et al. Microelectrode recording (MER) findings during sleep-awake anesthesia using dexmedetomidine in deep brain stimulation surgery for Parkinson’s disease. Clin Neurol Neurosurg. 2016;143:27–33.CrossRefPubMedCentralPubMedGoogle Scholar
Martinez-Simon A, Alegre M, Honorato-Cia C, et al. Effect of dexmedetomidine and propofol on basal ganglia activity in Parkinson disease: a controlled clinical trial. Anesthesiology. 2017;126(6):1033–42.CrossRefPubMedCentralPubMedGoogle Scholar
Bindu B, Bithal PK. Anaesthesia and deep brain stimulation. J Neuroanaesthesiol Crit Care. 2016;3:197–204.CrossRefGoogle Scholar
Chen T, Mirzadeh Z, Chapple K, et al. “Asleep” deep brain stimulation for essential tremor. J Neurosurg. 2015;27:1–8.Google Scholar
Moro E, Lozano AM, Pollak P, et al. Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson’s disease. Mov Disord. 2010;25:578–86.CrossRefPubMedCentralPubMedGoogle Scholar
Larson PS, Richardson RM, Starr PA, Martin AJ. Magnetic resonance imaging of implanted deep brain stimulators: experience in a large series. Stereotact Funct Neurosurg. 2008;86:92–100.CrossRefPubMedCentralPubMedGoogle Scholar