Choice of Anesthesia in Microelectrode Recording-guided Deep Brain Stimulation Surgery for Parkinson's Disease (CHAMPION): A Noninferiority Randomized Controlled Trial.

Sining Xie; Lin Shi; Wei Xiong; Yifang Fan; Liang Chen; Xiangjiahui Li; Yuanyuan Tong; Anchao Yang; Fangang Meng; Anxin Wang; Jianguo Zhang; Ruquan Han

doi:10.1097/aln.0000000000006133

PubMed · 42102350

Choice of Anesthesia in Microelectrode Recording-guided Deep Brain Stimulation Surgery for Parkinson's Disease (CHAMPION): A Noninferiority Randomized Controlled Trial.

Sining Xie·Lin Shi·Wei Xiong·Yifang Fan·Liang Chen·Xiangjiahui Li·Yuanyuan Tong·Anchao Yang·Fangang Meng·Anxin Wang·Jianguo Zhang·Ruquan Han

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Abstract

BACKGROUND: Deep brain stimulation for Parkinson's disease is often performed under conscious sedation or general anesthesia. However, anesthetic agents may influence intraoperative microelectrode recording, and the optimal anesthesia method for microelectrode recording remains unclear. This study compared general anesthesia and conscious sedation in preserving microelectrode recording signal intensity during deep brain stimulation. METHODS: In this prospective, noninferiority randomized controlled trial, patients with Parkinson's disease (United Kingdom Brain Bank criteria) undergoing elective bilateral surgery were randomized 1:1 to the conscious sedation or the general anesthesia group. During surgery, a desflurane anesthetic titrated against the quality of the electrophysiologic signal was applied in the general anesthesia group, whereas patients in the conscious sedation group received dexmedetomidine anesthesia. The primary outcome was the proportion of patients with high-quality microelectrode recording (normalized root mean square greater than 2.0), assessed postoperatively off-line. Secondary outcomes included operation and recording duration, 6-month clinical efficacy, and complication rates. RESULTS: Of 188 randomized patients (94 general anesthesia, 93 conscious sedation), desflurane anesthesia was noninferior for high normalized root mean square proportion (89.4% vs . 90.3%; difference, -0.96%; 95% CI, -9.62 to 7.70). The general anesthesia group had shorter operative time (difference, -9.07 min; 95% CI, -13.99 to -4.14; P < 0.001). At 6 months, changes in Unified Parkinson's Disease Rating Scale score (difference, -2.50; 95% CI, -7.20 to 2.20; P = 0.297), levodopa equivalent daily dose (difference, -58.4 mg; 95% CI, -133.56 to 16.75; P = 0.128), and complication rates (general anesthesia: 10.9% vs . conscious sedation: 8.9%; P = 0.655) were comparable between the groups. CONCLUSIONS: General anesthesia is noninferior to conscious sedation for microelectrode-guided subthalamic nucleus deep brain stimulation, providing equivalent signal intensity and clinical outcomes while improving procedural efficiency, supporting its use as a valid clinical option.

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Humans Deep Brain Stimulation Parkinson Disease Female Microelectrodes Male Aged Anesthesia, General Prospective Studies Procedural Sedation Middle Aged Desflurane Dexmedetomidine Anesthetics, Inhalation Journal Article Randomized Controlled Trial Equivalence Trial

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Sining Xie, Lin Shi, Wei Xiong, Yifang Fan, Liang Chen, Xiangjiahui Li, Yuanyuan Tong, Anchao Yang, Fangang Meng, Anxin Wang, Jianguo Zhang, Ruquan Han. 2026-05-08. Choice of Anesthesia in Microelectrode Recording-guided Deep Brain Stimulation Surgery for Parkinson's Disease (CHAMPION): A Noninferiority Randomized Controlled Trial.. https://doi.org/10.1097/aln.0000000000006133

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Aged subject Anesthesia, General subject Dexmedetomidine subject Equivalence Trial subject Female subject Humans subject Journal Article subject Male subject Middle Aged subject Parkinson Disease subject Randomized controlled trials study

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