Awake versus asleep deep brain stimulation for Parkinson’s disease: a critical comparison and meta-analysis

Journal of Neurology, Neurosurgery & Psychiatry
Published online 1 March 2017.

Allen L HoRohaid AliIan D ConnollyJaimie M HendersonRohit DhallSherman C SteinCasey H Halpern


Objective No definitive comparative studies of the efficacy of ‘awake’ deep brain stimulation (DBS) for Parkinson’s disease (PD) under local or general anaesthesia exist, and there remains significant debate within the field regarding differences in outcomes between these two techniques.

Methods We conducted a literature review and meta-analysis of all published DBS for PD studies (n=2563) on PubMed from January 2004 to November 2015. Inclusion criteria included patient number >15, report of precision and/or clinical outcomes data, and at least 6 months of follow-up. There were 145 studies, 16 of which were under general anaesthesia. Data were pooled using an inverse-variance weighted, random effects meta-analytic model for observational data.


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