Holewijn RA, Verbaan D, van den Munckhof PM, et al. - The primary outcome of asleep vs awake deep brain stimulation (DBS) was the same.

• In total, 110 patients were randomized to awake (local anesthesia; n = 56; mean [SD] age, 60.0 (7.4) years; 40 [71%] male) or to asleep (general anesthesia; n = 54; mean [SD] age, 61.3 [7.9] years; 38 [70%] male) DBS surgery One hundred three participants completed the 6-month follow-up visit.

• The proportion of patients with negative cognitive, mood, and behavioural effects on the composite score after awake DBS was 15 of 52 (29%) and 11 of 51 (22%) after asleep DBS.

• No difference was found in improvement in the off-medication Movement Disorders Society Unified Parkinson’s Disease Rating Scale Motor Examination scores between groups (awake group: mean [SD], −27.3 [17.5] points; asleep group: mean [SD], −25.3 [14.3] points; mean difference, −2.0 [95% CI, −8.1 to 4.2]).

• Patients perceived asleep surgery to be less burdensome, and it took 26 minutes less time than awake surgery.