Richard Smeyne, PhD, Director of the Jefferson Comprehensive Parkinson’s Center at Thomas Jefferson University in Philadelphia, said that the asleep procedure is the newer one and can target either the GPi or the STN. “The asleep DBS seems to have a little bit better improvement on speech afterwards than the awake DBS, and there could be several causes of this,” he said. “Some might be operative, in that you can make smaller holes, you can get really nice guidance, you do not have to sort of move around as in the awake DBS.”
In addition, CT scanning with the patients asleep in the operating room allows more time in the scanner and greater precision in anatomical placement of the DBS leads.
“If I had to choose, looking at this particular study, it would suggest that the asleep DBS is actually a better overall way to go,” Dr. Smeyne said. However, he had no objection to awake procedures “if the neurosurgeon has a record of good results with it .... But if you have the option ... that becomes an individual choice that you should discuss with the neurosurgeon.”
Some of the work presented in the study was supported by a research grant from Medtronic.
—Daniel M. Keller