Next Article in Journal / Special Issue
DBS in Treatment of Post-Traumatic Stress Disorder
Previous Article in Journal
Depression Symptom Patterns and Social Correlates among Chinese Americans
Previous Article in Special Issue
Stereotactically Standard Areas: Applied Mathematics in the Service of Brain Targeting in Deep Brain Stimulation
Article Menu
Issue 1 (January) cover image

Export Article

Open AccessReview
Brain Sci. 2018, 8(1), 17;

Awake versus Asleep Deep Brain Stimulation Surgery: Technical Considerations and Critical Review of the Literature

Department of Neurosurgery, Rush University Medical Center, Chicago, IL 60612, USA
Author to whom correspondence should be addressed.
Received: 15 December 2017 / Revised: 8 January 2018 / Accepted: 16 January 2018 / Published: 19 January 2018
Full-Text   |   PDF [197 KB, uploaded 19 January 2018]


Advancements in neuroimaging have led to a trend toward direct, image-based targeting under general anesthesia without the use of microelectrode recording (MER) or intraoperative test stimulation, also referred to as “asleep” deep brain stimulation (DBS) surgery. Asleep DBS, utilizing imaging in the form of intraoperative computed tomography (iCT) or magnetic resonance imaging (iMRI), has demonstrated reliable targeting accuracy of DBS leads implanted within the globus pallidus and subthalamic nucleus while also improving clinical outcomes in patients with Parkinson’s disease. In lieu, of randomized control trials, retrospective comparisons between asleep and awake DBS with MER have shown similar short-term efficacy with the potential for decreased complications in asleep cohorts. In lieu of long-term outcome data, awake DBS using MER must demonstrate more durable outcomes with fewer stimulation-induced side effects and lead revisions in order for its use to remain justifiable; although patient-specific factors may also be used to guide the decision regarding which technique may be most appropriate and tolerable to the patient. View Full-Text
Keywords: awake; asleep; DBS; targeting; stereotaxis awake; asleep; DBS; targeting; stereotaxis
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

Share & Cite This Article

MDPI and ACS Style

Kochanski, R.B.; Sani, S. Awake versus Asleep Deep Brain Stimulation Surgery: Technical Considerations and Critical Review of the Literature. Brain Sci. 2018, 8, 17.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics



[Return to top]
Brain Sci. EISSN 2076-3425 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top