To compare awake and asleep deep brain stimulation (DBS) surgery for Essential Tremor (ET), we conducted this retrospective cohort study of patients consecutively operated with DBS targeting the caudal Zona incerta (cZi). 37 underwent surgery awake and 55 asleep. Tremor before surgery and on/off stimulation one year after surgery were evaluated using the Essential Tremor Rating Scale (ETRS). Procedural time, electrode localization, stimulation parameters and adverse events were noted and compared. ETRS scores were similar at baseline between the groups except for contralateral arm tremor, which was slightly worse in the awake group. Total ETRS, contralateral arm tremor and activities of daily living scores showed no significant difference between the groups on-stimulation at one-year follow-up. Compared to the awake group, the asleep group had shorter procedural time and lower stimulation parameters. There were no intracranial haemorrhages nor surgery site-infections. Both groups showed a good improvement of tremor at one-year follow-up. Image-guided DBS surgery targeting the cZi enables safe and efficient asleep surgery for ET.

为了比较清醒和睡眠时脑深部刺激 （DBS） 手术对特发性震颤 （ET） 的影响，我们对针对尾部不定带 （cZi） 的连续 DBS 手术的患者进行了这项回顾性队列研究。37 例清醒接受手术，55 例睡着。使用特发性震颤评定量表 （ETRS） 评估手术前的震颤和手术后 1 年的开/关刺激。记录并比较程序时间、电极定位、刺激参数和不良事件。两组之间的基线 ETRS 评分相似，但对侧手臂震颤除外，清醒组略差。总 ETRS、对侧手臂震颤和日常生活活动评分显示，在一年的随访中，刺激组之间没有显着差异。与清醒组相比，睡眠组的手术时间更短，刺激参数更低。没有颅内出血，也没有手术部位感染。两组在一年的随访中均显示震颤有良好的改善。针对 cZi 的图像引导 DBS 手术可实现安全高效的 ET 睡眠手术。