JAMA Neurol: The effect of deep brain stimulation of the subthalamic nucleus under general anesthesia on the clinical symptoms of Parkinson's patients

Deep brain stimulation of the subthalamic nucleus (DBS) is an effective way to treat patients with severe Parkinson's disease.
Electrodes are usually implanted under local anesthesia, and stimulation tests are used to determine the best position of the electrodes.
Repeated stimulation tests cause patients A severe burden can lead to adverse events such as anxiety and exhaustion
.

Under general anesthesia, the placement of electrodes can also be determined by magnetic resonance imaging (MRI) or intraoperative microelectrode recording

Recently, researchers carried out a GALAXY study to investigate the effect of deep brain stimulation of the subthalamic nucleus on the symptoms of Parkinson's patients under general anesthesia or local anesthesia

From May 2015 to March 2019, a total of 187 Parkinson’s disease patients were prepared to receive DBS treatment.
They were randomly divided into bilateral subthalamic nucleus DBS under general anesthesia or local anesthesia.
In the trial, intraoperative microelectrode recording technology was used to Optimize the final target position of DBS
.

The primary endpoint of the study was the difference in cognitive, emotional, and behavioral adverse reactions between the groups after 6 months.

The local anesthesia group included 56 patients, with an average age of 60.
0 years, and men accounted for 71%, and the general anesthesia group included 54 patients, with an average age of 61.
3 years, and men accounted for 70%
.

103 patients completed the 6-month follow-up

At the 6-month comprehensive evaluation, the proportion of patients with cognitive, emotional, and behavioral abnormalities was as follows: 15 out of 52 in the local anesthesia group (29%), and 11 out of 51 in the general anesthesia group (22%, odds ratio = 0.

Primary endpoint difference between groups

Primary endpoint difference between groups

According to the study, compared with local anesthesia, deep brain stimulation of the subthalamic nucleus in Parkinson's patients under general anesthesia has no significant effect on the improvement of patients' cognitive, emotional and behavioral adverse reactions, but the surgical burden is reduced and the operation time is shortened
.

Compared with local anesthesia, in patients with Parkinson's under general anesthesia, deep brain stimulation of the subthalamic nucleus has no significant effect on the improvement of patients' cognitive, emotional and behavioral adverse reactions, but the burden of surgery is reduced and the operation time is shortened
.

Compared with local anesthesia, in patients with Parkinson's under general anesthesia, deep brain stimulation of the subthalamic nucleus has no significant effect on the improvement of patients' cognitive, emotional and behavioral adverse reactions, but the burden of surgery is reduced and the operation time is shortened

Original source:

Rozemarije A et al.

General Anesthesia vs Local Anesthesia in Microelectrode Recording-Guided Deep-Brain Stimulation for Parkinson Disease The GALAXY Randomized Clinical Trial.
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