To analyze the accuracy of electrode placement and curative effect of subthalamic nucleus deep brain stimulation (STN-DBS) guided by image alone in patients with Parkinson’s disease (PD).

Twenty-one patients with PD who underwent STN-DBS from June 2017 to January 2019 in Neurosurgery Department of the Seventh Medical Center, Chinese PLA General Hospital were retrospectively analyzed. They were divided into local anesthesia group (first 8 cases) and general anesthesia group (last 13 cases). In the local anesthesia group, electrodes were implanted under local anesthesia, and the implantation position was verified and corrected by intraoperative microelectrode recording and clinical tests. In the general anesthesia group, electrodes were implanted under general anesthesia, and the implantation position was verified and corrected by intraoperative CT scanning. The accuracy of target implantation, operation time and postoperative efficacy were compared between the two procedures.

All patients were safely implanted with bilateral electrodes and were followed up for at least 6 months after operation. The euclidean error of both electrodes in the general anesthesia group was less than that in the local anesthesia group, and the difference was statistically significant (P<0.05). There was no significant difference in radial error between 2 groups (P>0.05). The operation time in the general anesthesia group was significantly shorter than that in the local anesthesia group (P<0.05). There was no significant difference in the improvement rate of unified PD rating scale Ⅲ and the decrease value of levodopa equivalent daily dose between the two groups at 6 months after the drug was switched on (P>0.05).

The accuracy and effectiveness of image-guided and intraoperative CT-verified asleep STN-DBS surgery are comparable to that of awake procedure.