Our Summary

This study was conducted to see if there was a difference in negative effects like changes in thinking, mood, and behavior in patients with advanced Parkinson’s disease who had a type of brain surgery called deep brain stimulation (DBS) while they were awake versus asleep. The researchers studied 110 patients who were put into two groups: one group had the surgery while they were awake and the other group had it while they were asleep. The patients were followed up six months after the surgery.

The study found that both groups had similar rates of negative effects. About 29% of the awake group and 22% of the asleep group experienced issues with thinking, mood, and behavior. The researchers also didn’t see a difference in how much the patients’ Parkinson’s symptoms improved between the two groups. However, patients who had the surgery while they were asleep found the procedure to be less stressful and it also took less time.

The researchers concluded that there was no significant difference between having DBS surgery while awake or asleep. They suggest that future studies should look at newer methods of doing DBS surgery while the patient is asleep.

FAQs

  1. Did the study find any difference in negative effects between patients who had DBS surgery awake versus asleep?
  2. Was there a difference in how much the patients’ Parkinson’s symptoms improved between the two groups?
  3. What were the benefits for patients who had the DBS surgery while they were asleep?

Doctor’s Tip

One helpful tip a doctor might tell a patient about brain surgery is to follow all pre-operative instructions carefully, such as fasting before surgery and avoiding certain medications. It is also important to discuss any concerns or questions with your healthcare team before the procedure. Additionally, post-operative care and follow-up appointments are crucial for monitoring recovery and addressing any potential complications. It is important to have a strong support system in place to help with the recovery process.

Suitable For

Patients who are typically recommended for brain surgery include those with:

  1. Tumors in the brain
  2. Epilepsy that is not controlled with medication
  3. Severe traumatic brain injury
  4. Parkinson’s disease that is not well-controlled with medication
  5. Essential tremor that is severe and not well-controlled with medication
  6. Chronic pain that is not responsive to other treatments
  7. Movement disorders such as dystonia or Tourette syndrome

It is important for patients to discuss with their healthcare provider the potential risks and benefits of brain surgery, as well as alternative treatment options, before making a decision.

Timeline

Before brain surgery:

  1. Patient undergoes a series of tests and evaluations to determine the best course of treatment.
  2. Patient meets with their surgical team to discuss the procedure, risks, and expected outcomes.
  3. Patient may undergo pre-operative imaging scans to plan the surgery.
  4. Patient may need to stop certain medications or adjust their diet before the surgery.

During brain surgery:

  1. Patient is prepped for surgery and given anesthesia.
  2. Surgeon performs the procedure, either with the patient awake or asleep depending on the type of surgery.
  3. Monitoring equipment is used to ensure safety and accuracy during the surgery.
  4. Surgery may take several hours to complete.

After brain surgery:

  1. Patient is monitored in a recovery room before being transferred to a hospital room.
  2. Patient may experience pain, swelling, and discomfort at the surgical site.
  3. Patient may need to stay in the hospital for a few days to recover.
  4. Patient will have follow-up appointments with their surgical team to monitor their progress and make any necessary adjustments to their treatment plan.

What to Ask Your Doctor

Some questions a patient should ask their doctor about brain surgery, specifically deep brain stimulation (DBS) surgery, include:

  1. What are the risks and benefits of having DBS surgery while awake versus asleep?
  2. How will having DBS surgery while awake or asleep impact my recovery time and overall experience?
  3. What are the potential negative effects on thinking, mood, and behavior that could occur after DBS surgery?
  4. How will the effectiveness of DBS surgery be evaluated in my specific case?
  5. Are there any alternative methods or technologies that could be considered for DBS surgery while asleep?
  6. How experienced is the surgical team in performing DBS surgery while awake or asleep?
  7. What will the follow-up care and monitoring look like after DBS surgery?
  8. How can I best prepare myself physically and mentally for DBS surgery while awake or asleep?
  9. Are there any specific lifestyle changes or precautions I should take before and after DBS surgery?
  10. What support resources are available for me and my family during the DBS surgery process?

Reference

Authors: Holewijn RA, Verbaan D, van den Munckhof PM, Bot M, Geurtsen GJ, Dijk JM, Odekerken VJ, Beudel M, de Bie RMA, Schuurman PR. Journal: JAMA Neurol. 2021 Oct 1;78(10):1212-1219. doi: 10.1001/jamaneurol.2021.2979. PMID: 34491267