Intracranial approach for sub-second monitoring of neurotransmitters during DBS electrode implantation does not increase infection rate.

Autor: Liebenow B; Neuroscience Graduate Program, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.; Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America., Williams M; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, United States of America., Wilson T; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, United States of America., Haq IU; Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America., Siddiqui MS; Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America., Laxton AW; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, United States of America., Tatter SB; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, United States of America., Kishida KT; Neuroscience Graduate Program, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.; Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Aug 22; Vol. 17 (8), pp. e0271348. Date of Electronic Publication: 2022 Aug 22 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0271348
Abstrakt: Introduction: Currently, sub-second monitoring of neurotransmitter release in humans can only be performed during standard of care invasive procedures like DBS electrode implantation. The procedure requires acute insertion of a research probe and additional time in surgery, which may increase infection risk. We sought to determine the impact of our research procedure, particularly the extended time in surgery, on infection risk.
Methods: We screened 602 patients who had one or more procedure codes documented for DBS electrode implantation, generator placement, programming, or revision for any reason performed at Wake Forest Baptist Medical Center between January 2011 through October 2020 using International Classification of Diseases (ICD) codes for infection. During this period, 116 patients included an IRB approved 30-minute research protocol, during the Phase 1 DBS electrode implantation surgery, to monitor sub-second neurotransmitter release. We used Fisher's Exact test (FET) to determine if there was a significant change in the infection rate following DBS electrode implantation procedures that included, versus those that did not include, the neurotransmitter monitoring research protocol.
Results: Within 30-days following DBS electrode implantation, infection was observed in 1 (0.21%) out of 486 patients that did not participate in the research procedure and 2 (1.72%) of the 116 patients that did participate in the research procedure. Notably, all types of infection observed were typical of those expected for DBS electrode implantation.
Conclusion: Infection rates are not statistically different across research and non-research groups within 30-days following the research procedure (1.72% vs. 0.21%; p = 0.0966, FET). Our results demonstrate that the research procedures used for sub-second monitoring of neurotransmitter release in humans can be performed without increasing the rate of infection.
Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: Dr. Ihtsham ul Haq has received salary support for research from Allergan, Boston Scientific, Great Lakes Neurotechnology, and Pfizer. He has consulted for compensation for Boston Scientific and Medtronics. He has received funding from the NINDS, the NIAA, and the Parkinson’s Foundation. Dr. Mustafa Siddiqui has received research support as a site Principal Investigator for clinical trials from Neuraly, University of Rochester, Michael J. Fox-Neuropoint Alliance, Theravance Biopharma, Impax Laboratories, Sun Pharma, Abbvie, Boston Scientific Neuromodulation, Biogen and Sunovion. He has received honoraria or non-financial support as scientific advisor from Abbvie and Boston Scientific Neuromodulation. Dr. Adrian Laxton is a consultant and member of the safety committee for Monteris Medical. Dr. Stephen Tatter has received research support as a Principal Investigator for clinical trials from from Arbor Pharmaceuticals and Monteris Medical, Inc. All other authors have no competing interests to declare.
Databáze: MEDLINE
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