Asleep DBS

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For more information on asleep DBS at Barrow please call (602) 406-3865 or complete our contact request form.

What is asleep DBS?

How is asleep DBS different from awake DBS?

What happens during asleep DBS surgery?

What are the benefits of asleep DBS over awake DBS?

What are the benefits of awake DBS over asleep DBS?

Does asleep DBS produce better results than awake DBS?

What conditions are treated with asleep DBS?

 

What is asleep DBS?

Asleep DBS surgery is performed while you are unconscious under general anesthesia. A CereTom™ portable computed tomography (CT) machine is used both to target and to verify accurate placement of your DBS electrodes at the time of surgery.

 

How is asleep DBS different from awake DBS?

Standard DBS is performed while you are awake and, if you have Parkinson’s disease, requires you to be off your medicine. Cellular recordings are performed to map the intended target, and surgery can last 4-6 hours. Your surgeon uses a local anesthetic to numb the tissue where the incision is made, and mild sedatives are administered to ward off anxiety.

The prospect of being awake on an operating table for brain surgery concerns some patients, as does the requirement to be off medicine. Asleep DBS eliminates the need for you to be kept awake and off medicine. The goal in asleep DBS is to accurately place the electrodes at the target selected by the surgeon preoperatively. This goal is accomplished through intraoperative imaging.

 

What happens during asleep DBS surgery?

After a neuroanesthesiologist has put you under general anesthesia, your surgeon places five reference markers on your head, and a preliminary CT is performed.

That data from the CT is merged with a magnetic resonance imaging (MRI) study obtained before surgery. Your neurosurgeon uses the MRI to plan the point of entry and target for the DBS electrodes. The information from the CT is then used to identify where your scalp incision is placed.

Once the surgery begins, two platforms are attached to your head—one for each DBS electrode. The platforms are used to establish the correct trajectory to guide the placement of the electrodes.

After your DBS electrodes have been placed, the CereTom™ is used again to verify that the electrodes have been accurately placed at the planned target.

Once the accuracy of your DBS electrode placement has been confirmed, your surgeon tucks the lead wires under your scalp in preparation for them to be connected to the generator device. In the second part of your procedure, the generator is placed under your collarbone.

 

What are the benefits of asleep over awake DBS?

The main benefit of asleep DBS over traditional awake DBS surgery is the improved patient experience. General anesthesia is used during the entire asleep procedure—you literally ‘sleep’ through your surgery. Other benefits include:
  • Parkinson’s patients can take their medicine on the day of surgery
  • the duration of surgery is dramatically reduced
  • the added time and risks associated with cellular recordings are avoided

In contrast, during awake DBS surgery the patient is kept alert during the operation. Being in this situation can be a source of considerable discomfort. Your surgeon must map the cells in the region of the target and rely on your feedback to determine optimal placement and to minimize stimulation-related side effects, all of which increase the complexity of the operation.

 

What are the benefits of awake DBS over asleep DBS?

Asleep DBS, although promising, is a new procedure. Many surgeons have more experience with traditional DBS. However, that trend may be reverse in the coming years.

 

Does asleep DBS produce better results than awake DBS?

CereTom™ DBS was developed in 2011 by Dr. Kim Burchiel, who was the first neurosurgeon in the United States to offer DBS. Barrow Neurological Institute is the second hospital in the world to offer CereTom™ DBS. In addition to improving the patient experience, we hope to show that this approach also improves the safety and efficacy of the procedure.

 

What conditions are treated with asleep DBS?

Asleep DBS is used to treat the movement disorders Parkinson’s disease, dystonia, and essential tremor.

As research demonstrates the efficacy of asleep DBS, Barrow may extend its use to other neurological disorders.

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Barrow Neurological Institute
350 W. Thomas Road
Phoenix, AZ 85013
(602) 406-3000