BACKGROUND Recent advances in methods used for deep brain stimulation (DBS) include subthalamic nucleus electrode implantation in the "asleep" patient without the traditional use of microelectrode recordings or intraoperative test stimulation. OBJECTIVE To examine the clinical outcome of patients who have undergone "asleep" DBS for the treatment of Parkinson disease using robot-assisted electrode delivery. METHODS This is a retrospective review of clinical outcomes of 152 consecutive patients. Their outcomes at 1 yr postimplantation are reported; these include Unified Parkinson's Disease Rating Scale (UPDRS) assessment, Tinetti Mobility Test, Parkinson's Disease Questionnaire (PDQ)-39 quality of life assessment, Mattis Dementia Rating Scale, Beck Depression Inventory, and Beck Anxiety. We also report on a new parietal trajectory for electrode implantation. RESULTS A total of 152 patients underwent assessment at 1 yr. UPDRS III improved from 39 to 20.5 (47%, P < .001). The total UPDRS score improved from 67.6 to 36.4 (46%, P < .001). UPDRS II scores improved from 18.9 to 10.5 (44%, P < .001) and UPDRS IV scores improved from 7.1 to 3.6 (49%, P < .001). There was a significant reduction in levodopa equivalent daily dose after surgery (mean: 35%, P < .001). PDQ-39 summary index improved by a mean of 7.1 points. There was no significant difference found in clinical outcomes between the frontal and parietal approaches. CONCLUSION "Asleep" robot-assisted DBS of the subthalamic nucleus demonstrates comparable outcomes with traditional techniques in the treatment of Parkinson disease.

中文翻译：

---

使用机器人辅助分娩和丘脑底核的解剖定位对帕金森病进行“睡眠”深部脑刺激的临床结果：一系列 152 名患者

背景技术用于深部脑刺激（DBS）的方法的最新进展包括在“睡着的”患者中植入丘脑底核电极，而无需传统地使用微电极记录或术中测试刺激。目的检查使用机器人辅助电极递送进行“睡眠”DBS 治疗帕金森病的患者的临床结果。方法 这是对 152 名连续患者的临床结果的回顾性研究。报告了他们在植入后 1 年的结果；这些包括统一帕金森病评定量表 (UPDRS) 评估、Tinetti 活动能力测试、帕金森病问卷 (PDQ)-39 生活质量评估、Mattis 痴呆评定量表、贝克抑郁量表和贝克焦虑。我们还报告了电极植入的新顶叶轨迹。结果 共有 152 名患者在 1 年时接受了评估。UPDRS III 从 39 提高到 20.5（47%，P < .001）。UPDRS 总分从 67.6 提高到 36.4（46%，P < .001）。UPDRS II 得分从 18.9 提高到 10.5（44%，P < .001），UPDRS IV 得分从 7.1 提高到 3.6（49%，P < .001）。手术后左旋多巴等效日剂量显着降低（平均值：35%，P < .001）。PDQ-39 综合指数平均提高了 7.1 分。额叶入路和顶叶入路的临床结果没有显着差异。结论“睡着”机器人辅助的丘脑底核 DBS 显示出与治疗帕金森病的传统技术相当的结果。