{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:40:43Z","timestamp":1790995243680,"version":"4.1.0"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Deep brain stimulation (DBS) performed under general anesthesia (\u201casleep\u201d DBS) has not been previously reported for essential tremor. This is in part due to the inability to visualize the target (the ventral intermediate nucleus [VIM]) on MRI. The authors evaluate the efficacy of this asleep technique in treating essential tremor by indirect VIM targeting.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors retrospectively reviewed consecutive cases of initial DBS for essential tremor performed by a single surgeon. DBS was performed with patients awake (n = 40, intraoperative test stimulation without microelectrode recording) or asleep (n = 17, under general anesthesia). Targeting proceeded with standardized anatomical coordinates on preoperative MRI. Intraoperative CT was used for stereotactic registration and lead position confirmation. Functional outcomes were evaluated with pre- and postoperative Bain and Findley Tremor Activities of Daily Living scores.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A total of 29 leads were placed in asleep patients, and 60 were placed in awake patients. Bain and Findley Tremor Activities of Daily Living Questionnaire scores were not significantly different preoperatively for awake versus asleep cohorts (p = 0.2). The percentage of postoperative improvement was not significantly different between asleep (48.6%) and awake (45.5%) cohorts (p = 0.35). Euclidean error (mm) was higher for awake versus asleep patients (1.7 \u00b1 0.8 vs 1.2 \u00b1 0.4, p = 0.01), and radial error (mm) trended higherfor awake versus asleep patients (1.3 \u00b1 0.8 vs 0.9 \u00b1 0.5, p = 0.06). There were no perioperative complications.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>In the authors\u2019 initial experience, asleep VIM DBS for essential tremor without intraoperative test stimulation can be performed safely and effectively.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.6.jns15526","type":"journal-article","created":{"date-parts":[[2015,11,27]],"date-time":"2015-11-27T14:59:35Z","timestamp":1448636375000},"page":"1842-1849","source":"Crossref","is-referenced-by-count":60,"title":["\u201cAsleep\u201d deep brain stimulation for essential tremor"],"prefix":"10.3171","volume":"124","author":[{"given":"Tsinsue","family":"Chen","sequence":"first","affiliation":[{"name":"Divisions of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaman","family":"Mirzadeh","sequence":"additional","affiliation":[{"name":"Divisions of Neurological Surgery 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